Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (1): 6-9.doi: 10.13418/j.issn.1001-165x.2020.01.002

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Anatomical study of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel   

ZHANG Yu-jun,JU Ji-hui,XU Lei,JIN Qian-heng,ZHAO Qiang,LI Xiang-jun,CHENG He-yun,WANG Ben-yuan   

  1. Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Jiangsu 215104,China
  • Received:2019-05-10 Online:2020-01-25 Published:2020-02-18

Abstract: Objective  To imitate the surgical methods of the central tendon reconstruction by manipulation of the superficial flexor tendon through bone tunnel,and to verify the feasibility and safety of the operation.  Methods Eight fresh adult cadavers hand specimens , with a total of 24 fingers in index finger, middle finger and ring finger,were collected to dissect and observe the anatomic structure of superficial flexor tendon, central tendon and extensor tendon. Four index fingers, four middle fingers and four ring fingers, 12 fresh adult finger specimens were selected for imitated operation. The rupture of central tendon insertion was artificially designed. Tendon bundles on both sides of flexor digitorum were passed through base of the middle palmar segment to dorsal part by drilling through the phalanx,and the rupture of central tendon insertion was reconstructed by woven suture with central tendon rupture. Then the passive stretch angle and the passive buckling angle of PIP formed by different suture spacing were measured. Results  When the suture spacing of superficial flexor tendon was large, the angle of passive extension and flexion were also large, but the central tendon and the superficial flexor tendon were loose obviously. When the suture spacing was small, the angle of passive extension and flexion were also small, the tension of the central tendon and the superficial flexor tendon were large. Therefore, none of them could ensure the flexion and extension of fingers. When the suture spacing of superficial flexor tendon was 1.5cm,the passive buckling angle of PIP was about 75°.When the suture spacing was 1.0cm,the passive buckling angle of PIP was about 30°. When the suture spacing was 1.0~1.5cm, that is, when cutting through the Camper tendon chiasma, the angle of passive stretch and flexion of PIP were closest to the functional angle of finger.  Conclusions  Central tendon insertion can be reconstructed when the superficial flexor tendon is removed to Camper tendon chiasma. The tendon injury in donor area is small, and the central tendon reconstruction is safe and feasible relatively.

Key words: Tendon injuries,  Tendon insertion,  Central tendon,  Anatomical study

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