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Multiple tendons of the additional belly of flexor pollicis longus in the carpal tunnel: Embryological perspective and their clinical significance

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Forensic Medicine and Anatomy Research 2013年第4期1卷 70-73页

作者： Ravindra Swamy Shantakumar Srinivasa Rao Sirasanagandla Satheesha Badagabettu Nayak Mohandas Rao Kappettu Gadahad Shiroor Nagabhushan Somayaji Naveen Kumar Melaka Manipal Medical College (Manipal Campus) Manipal University Manipal India

Although the flexor pollicis longus is known to show the additional head of the origin, the occurrence of its additional tendons in the carpal tunnel are seldom reported. The presence of such additional tendons in the carpal tunnel cannot be overlooked during the radiological and surgical procedures in this region. Herein, we report a rare case of additional muscle belly of flexor pollicis longus. The additional muscle belly after a short course divided into three tendons. All three tendons entered the carpal tunnel along with flexor pollicis longus, passing deep to the flexor retinaculum. Within the carpal tunnel, two of these tendons fused and terminated by merging with the undersurface of the flexor retinaculum. The third tendon terminated by joining the flexor digitorum superficialis tendon for the index finger, in the palm. An additional slip of the first lumbrical muscle took origin from the third tendon of the additional muscle belly of flexor pollicis longus. Further, the embryological basis and clinical significance of current case is discussed.

关键词： Flexor Pollicis longus Additional Muscle Belly Flexor Retinaculum Carpal Tunnel First Lumbrical

Tarsal Tunnel Syndrome—A New Way to Diagnose an Old Problem

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World Journal of Neuroscience 2017年第1期7卷 172-180页

作者： Conor O’Brien Rob Byrden Neurophysiology Department Sports Surgery Clinic Santry Dublin Ireland Department of Engineering University College Dublin Ireland

Tarsal Tunnel Syndrome [TTS] is the most common lower limb focal neuropathy but it has a poor pick up rate in most Electrodiagnostic (EXD) Laboratories. There is no gold standard for assessing TTS. The tibial nerve has a complex branching system with 4 main branches and 9 different patterns of division. This study evaluated potential TTS with a similar and extensive assessment of the tibial nerve. The protocol involved 2 tibial motor studies to the Adductor Hallucis longus (AH) and Adductor Digiti Quinti (ADQ) muscles, assessing amplitudes and distal latencies;medial plantar, lateral plantar and calcaneal sensory studies assessing amplitudes and distal latencies. A needle EMG to the tibial innervated AH and ADQ muscles was also performed. This protocol evaluated 12 different parameters which significantly increased the diagnostic yield. TTS has a low pick up rate using current standard assessment methods accounting for between 0.5% and 0.6% of positive cases referred to electrodiagnostic laboratories. This study had a pick up rate of 3.3% with 40 positive cases identified out of a population of 1210 patients referred to an electrodiagnostic laboratory in a calendar year. A combination of positive findings was observed. There were on average 4.3 positive parameters. The calcaneal sensory study and the needle EMG to the distal AH and ADQ muscles were the most sensitive tests. These 3 tests are not routinely performed in most labs. Of the 40 cases of TTS over 80% had a history of either prior injury or surgery to affected lower limb. This study suggests that this 12 parameter assessment will increase diagnostic sensitivity.

关键词： Tarsal Tunnel Syndrome Electrodiagnostic Tibial Nerve Focal Neuropathy Adductor Hallucis longus Adductor Digiti Quinti

Mechanisms of change contraction of function of the muscles <i>in vitro</i>at allergic

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Health 2014年第5期6卷 387-391页

作者： Alexander Y. Teplov Albert M. Farkhutdinov Vladimir I. Torshin Department of Pathophysiology Kazan State Medical University Kazan Russia Department of Physiology Russian People’s Friendship University Moscow Russia

In this work, mechanisms of influence of protein sensibility of an organism on contractile function of the isolated skeletal muscles of the mouse—“fast”—musculus extensor digitorum longus, “mixed”—musculus diaphragma and “slow”— musculus soleus are investigated. It is shown that at a protein sensitization all “fast”, “mixed” and “slow” skeletal muscles change the contractile properties. The vector of these changes for muscles with a various phenotypes carries opposite character. Force of the reduction caused carbacholine at a “slow” and “mixed” muscles increase, at “fast”—decreases. A vector of change of force of reduction on carbacholine at protein sensitization at these skeletal muscles correlates with changes of non-quantum secretion acetylcholine in a zone of a trailer plate. Opposite changes of functional properties of “fast” and “mixed” muscles and “slow” muscles of a shin of the mouse at protein sensitization are caused by dynamics cholinoceptive processes of excitation of membrane muscular fibers. It comes out with the assumption, that change of the contraction functions of skeletal muscles at protein sensitization is caused by changes of cholinoceptive processes of excitation of a membrane of muscular fibers, and other changes in system of electro-mechanical interface.

关键词： Skeletal Muscle Contraction Characteristics Extensor Digitorum longus Soleus Diaphragm Non-Quantum Secretion Protein Sensitization

Autologous Tendon Grafts Used in Upper Limb Surgery

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Open Journal of Orthopedics 2013年第2期3卷 74-78页

作者： Avinash Alva V. Kumar R. Sreekumar Chye Yew Ng S. C. Talwalkar Blackpool Victoria Hospital Blackpool UK Department of Orthopaedics Wrightington Hospital Wigan UK

Tendon autografts play an important role in upper limb reconstruction and a working knowledge of tendon autograft options is essential for the surgeon. Although palmaris longus is often the first choice, other options like plantaris, extensor Hallucis longus, flexor carpi radialis are readily available. Advantages of autografts include easy availability, satisfactory biomechanical properties and the human body tends to accept its own tendons than from a donor. This review highlights the various options available and their anatomical and surgical considerations in procuring grafts for upper limb reconstructive work.

关键词： Autologous Tendon Graft Palmaris longus Plantaris Extensor Digitorum longus Extensor Hallucis longus Flexor Carpi Radialis Hamstrings

Mallet Toe of the Hallux Treated by Bridging Suture Technique Using Suture Anchors: A Case Report and Literature Review

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Open Journal of Orthopedics 2019年第5期9卷 123-129页

作者： Akira Ando Tsutomu Kobayashi Masashi Koide Michimasa Matsuda Yoshihiro Hagiwara Eiji Itoi Department of Orthopaedic Surgery Matsuda Hospital Sendai Japan Department of Orthopaedic Surgery Tohoku University School of Medicine Sendai Japan

An avulsion fracture of the extensor hallucis longus at the distal end of the great toe is called “mallet toe” of the hallux. It is a rare injury and the treatment options are conservative treatment using a splint, percutaneous or open Kirschner wire fixation similar to that in the mallet finger, or suture anchor fixation. We present a case treated by the bridging technique using two suture anchors. A 57-year-old Japanese man injured his left great toe after a fall while walking barefoot on the bed. His great toe was forced into a hyperplantarflexion position. Plain radiography and computed tomography showed a small bone fragment at the base of the dorsal distal phalanx, suggesting an avulsion fracture of the extensor hallucis longus. He was treated by bridging suture technique with two suture anchors. At first, two suture anchors were inserted to the fracture bed of the distal phalanx, and then the bone fragment and extensor hallucis longus tendon were secured with two horizontal mattress sutures. Finally, bridging sutures were performed using the remaining sutures and the sutures used for mattress suturing. He obtained bony union and symmetric range of motion of the interphalangeal joint. This technique allowed us to fix the small bone fragment rigidly and mobilize the interphalangeal joint earlier to preserve the range of motion. It would be a valuable procedure when the bone fragment is small.

关键词： Mallet Toe Hallux Avulsion Fracture Extensor Hallucis longus Suture Anchor