Fibro-osseous Sheath Research Articles

Rock climbing injuries.

Three-quarters of elite and recreational sport climbers will suffer upper extremity injuries. Approximately 60% of these injuries will involve the hand and wrist, the other 40% will be equally divided between the elbow and the shoulder. Most injuries will be tendonopathies secondary to strains, microtrauma or flexor retinacular irritation. However, up to 30% of these injuries in up to 50% of elite climbers will involve the proximal interphalangeal (PIP) region. These injuries are more serious and consist of varying degrees of flexor digitorum sublimis insertional strains, digital fibro-osseous sheath ruptures and PIP joint collateral ligament strains. Early changes in climbing schedules, stretching and exercise habits, and protective digital taping are necessary to protect and rehabilitate these athletes.

Acute traumatic subluxation of the extensor carpi ulnaris tendon at the wrist

A case of acute traumatic subluxation of the extensor carpi ulnaris tendon as it passes through the sixth compartment of the wrist is described. The literature suggests that acute injuries can be treated for 6 weeks in a long arm cast, with the forearm in pronation and slight radial deviation and dorsiflexion, but there are no case reports described. The findings in this case suggest that for optimal results, surgical repair of the retaining fibro-osseous sheath of the extensor carpi ulnaris is preferable over the nonoperative cast technique.

Transferring the flexor superficialis tendon: Technical considerations in the prevention of proximal interphalangeal joint disability

Transfer of the flexor digitorum superficialis tendon to restore functional loss may result in a flexion contracture or hyperextension deformity of the proximal interphalangeal joint of the donor finger. Removal of the flexor tendon through the membranous interval in the fibro-osseous sheath between the annular pulley (A2) and the proximal collar (A1) avoids scarring of the structures volar to the proximal interphalangeal joint. Sixteen flexor superficialis tendons were removed at this membranous interval for transfer. No functional impairment from flexion contracture or hyperextension deformity developed after operation in the donor fingers, although an average 8 degrees of loss of extension was noted at the proximal interphalangeal joint in 50% of the donor fingers.