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. 2024 Feb 10;16(2):e53963.
doi: 10.7759/cureus.53963. eCollection 2024 Feb.

Secondary Repair of Jersey Finger: A Novel Method of Tendon Length Estimation via Measurement of Adjacent Landmarks

Arjan Singh Sehmbi  1 , Mobin Syed  2 , Aashtad Cyrus Daruwalla  1 , Peter Rae  1 , Isaac Harris  1 , Savan Shah  3 , David Parry  4
Affiliations

Secondary Repair of Jersey Finger: A Novel Method of Tendon Length Estimation via Measurement of Adjacent Landmarks

Arjan Singh Sehmbi et al. Cureus. .

Abstract

Jersey finger describes the rupture of the flexor digitorum profundus (FDP) tendon at its insertion into the distal phalanx. In the absence of an evidence-based approach to tensioning during secondary repair, we aimed to devise a novel method to determine the required tendon length pre/intraoperatively. We measured anatomical landmarks, associated with the FDP tendon, on dissected cadavers, to assess whether these can be used to estimate tendon segment lengths. Eight cadaveric hands were dissected. Three measurements from the distal lumbrical origin to (1) FDP insertion, (2) the distal end of A1 (Annular 1 pulley), and (3) the proximal end of A1 were recorded for digits II-V. Relative ratios for measurement 1 were consistent for all digits, compared to digit III. Linear regression analysis confirmed a strong correlation for measurement 1 between digit II (R2 =0.97) and digit IV(R2 =0.97) compared to digit III across all specimens. Digit III distal lumbrical origin to FDP insertion measurements could facilitate the estimation of the required graft length for digit II or IV during secondary repair. This is a level IV study, providing proof of concept for a novel method of tendon tensioning.

Keywords: fdp avulsion; flexor digitorum profundus tendon; jersey finger; secondary repair; tendon avulsion rupture.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Palmar and digital incisions made during dissection
Figure 2
Figure 2. Key anatomical landmarks identified during dissection
A: Lumbrical muscle to digit II; B: A1 pulley over digit II; C: FDP tendon distal insertion in digit V
Figure 3
Figure 3. Measurements taken illustrated on the anterior surface of the left hand
Image credits: Dr. Arjan S Sehmbi
Figure 4
Figure 4. Ratio of distal point of lumbrical origin to FDP insertion length between digits III and II
Statistical test: linear regression (y) and coefficient of determination (R2) FDP: flexor digitorum profundus
Figure 5
Figure 5. Ratio of distal point lumbrical origin to the FDP insertion length between digits III and IV
Statistical test: linear regression (y) and coefficient of determination (R2) FDP: flexor digitorum profundus
Figure 6
Figure 6. Ratio of distal point lumbrical origin to the FDP insertion length between digits III and V
Statistical test: Linear regression (y) and coefficient of determination (R2)
See this image and copyright information in PMC

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