Carter Jordan T, Polmear Michael, Herrera Fernando, Gonzalez Gilberto
Orthopaedics, Texas Tech University Health Sciences Center, El Paso, USA.
Plastic Surgery, Medical University of South Carolina, Charleston, USA.
Cureus. 2020 Feb 11;12(2):e6948. doi: 10.7759/cureus.6948.
The flexor digitorum superficialis (FDS) is the only muscle in the intermediate layer of the flexor compartment of the forearm. Its main function is flexion of the proximal interphalangeal (IP) joint. Variations of the FDS are common, and knowledge of these variations is necessary for hand surgeons because the little finger tendon of the FDS is commonly used in hand reconstruction surgery. Here we present a case of bilateral absence of the little finger tendon of the FDS in an 11-year-old Hispanic female trauma patient presenting to the Emergency Department with multiple traumatic injuries including bilateral hand lacerations sustained in a motor vehicle accident. On physical examination, flexion of the IP joint of the thumb, and metacarpal phalangeal, proximal IP, and distal IP joints of the little finger were absent bilaterally. In the operating theater, the lacerations were extended to evaluate the status of the tendons of the FDS and flexor digitorum profundus (FDP). On the right, a complete transection of the FDP tendons to the ring and little fingers were found and repaired. Upon further exploration, the FDS tendon to the ring finger was identified and repaired, whereas the little finger tendon was found to be absent. On the left, the FPL tendon was identified and repaired along with the FDP tendon to the little finger. The FDS was subsequently identified and found to be lacking the tendon to the little finger. Clinically, the absence of the FDS could lead to problems in hand reconstruction surgery and functional testing of the hand.
指浅屈肌（FDS）是前臂屈肌间隙中间层的唯一肌肉。其主要功能是屈曲近侧指间（IP）关节。FDS的变异很常见，手部外科医生有必要了解这些变异，因为FDS的小指肌腱常用于手部重建手术。在此，我们报告一例11岁西班牙裔女性创伤患者，因包括在机动车事故中双侧手部裂伤在内的多处创伤性损伤就诊于急诊科，其双侧FDS小指肌腱缺如。体格检查发现，双侧拇指IP关节以及小指的掌指关节、近侧IP关节和远侧IP关节均无法屈曲。在手术室，将裂伤扩大以评估FDS和指深屈肌（FDP）肌腱的状况。右侧发现FDP至环指和小指的肌腱完全横断并进行了修复。进一步探查时，识别并修复了FDS至环指的肌腱，而发现小指肌腱缺如。左侧识别并修复了拇长屈肌腱以及FDP至小指的肌腱。随后识别出FDS，发现其小指肌腱缺如。临床上，FDS缺如可能会导致手部重建手术和手部功能测试出现问题。
