Kim Jihyeung, Rhee Seung Hwan, Gong Hyun Sik, Oh Sohee, Baek Goo Hyun
Department of Orthopaedic Surgery, Seoul National University, College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Republic of Korea.
J Orthop Res. 2015 May;33(5):717-25. doi: 10.1002/jor.22798. Epub 2015 Mar 2.
Patients with longstanding trigger finger may develop flexion contracture at the proximal interphalangeal (PIP) joint that persists even after division of the A1 pulley. The purpose of this study was to explore the hypothesis that flexion deformity of the PIP joint in advanced trigger finger is caused by severe adhesion between the flexor digitorum superficialis (FDS) and the flexor digitorum profundus (FDP) tendons. Ten freshly frozen cadaveric hands were used in the experiments. After preparation of the extrinsic flexor, extrinsic extensor, and intrinsic muscle tendons, we applied weights to the flexor tendons and minimal tension to the extrinsic extensor and intrinsic muscle tendons. We then measured the initial flexion angles of the metacarpophalangeal (MCP) and PIP joints. Next, we measured the flexion angles of the MCP and PIP joints as increasing tension was applied to the extrinsic extensor and intrinsic muscle tendons, respectively. We repeated these experiments after constructing flexor tendon adhesion model. The initial flexion angles of the MCP and PIP joints were greater in the adhesion model, as were the average tensions required for full extension of these joints. Our results suggest that adhesion between two flexor tendons contributes to progression of flexion deformity in the PIP joint.
患有长期扳机指的患者可能会在近端指间关节（PIP）出现屈曲挛缩，即使在A1滑车松解后这种挛缩仍会持续。本研究的目的是探讨晚期扳机指中PIP关节屈曲畸形是由指浅屈肌（FDS）和指深屈肌（FDP）肌腱之间严重粘连所致这一假说。实验使用了10只新鲜冷冻的尸体手。在准备好外在屈肌、外在伸肌和内在肌腱后，我们给屈肌腱施加重量，并给外在伸肌和内在肌腱施加最小张力。然后我们测量掌指关节（MCP）和PIP关节的初始屈曲角度。接下来，当分别给外在伸肌和内在肌腱施加逐渐增加的张力时，我们测量MCP和PIP关节的屈曲角度。在构建屈肌腱粘连模型后，我们重复了这些实验。在粘连模型中，MCP和PIP关节的初始屈曲角度更大，这些关节完全伸直所需的平均张力也是如此。我们的结果表明，两条屈肌腱之间的粘连会导致PIP关节屈曲畸形的进展。
