Finger Flexor Research Articles

Identification of distinct immune signatures in inclusion body myositis by peripheral blood immunophenotyping using machine learning models.

Inclusion body myositis (IBM) is a progressive late-onset muscle disease characterised by preferential weakness of quadriceps femoris and finger flexors, with elusive causes involving immune, degenerative, genetic and age-related factors. Overlapping with normal muscle ageing makes diagnosis and prognosis problematic. We characterised peripheral blood leucocytes in 81 IBM patients and 45 healthy controls using flow cytometry. Using a random forest classifier, we identified immune changes in IBM compared to HC. K-means clustering and the random forest one-versus-rest model classified patients into three immunophenotypic clusters. Functional outcome measures including mTUG, 2MWT, IBM-FRS, EAT-10, knee extension and grip strength were assessed across clusters. The random forest model achieved a 94% AUC ROC with 82.76% specificity and 100% sensitivity. Significant differences were found in IBM patients, including increased CD8+ T-bet+ cells, CD4+ Tcells skewed towards a Th1 phenotype and altered γδ Tcell repertoire with a reduced proportion of Vγ9+Vδ2+ cells. IBM patients formed three clusters: (i) activated and inflammatory CD8+ and CD4+ T-cell profile and the highest proportion of anti-cN1A-positive patients in cluster 1; (ii) limited inflammation in cluster 2; (iii) highly differentiated, pro-inflammatory T-cell profile in cluster 3. Additionally, no significant differences in patients' age and gender were detected between immunophenotype clusters; however, worsening trends were detected with several functional outcomes. These findings unveil distinct immune profiles in IBM, shedding lightonunderlying pathological mechanisms for potential immunoregulatory therapeutic development.

Five weeks of dynamic finger flexor strength training on bouldering performance and climbing-specific strength tests. A randomized controlled trial.

The aim of the study was to examine the effects of a 5-week dynamic finger flexor strength training program on bouldering performance and climbing-specific strength tests. Advanced to elite level boulderers (n = 31) were randomized to a dynamic finger strength training group (DFS) or a control group (CON). The DFS training program consisted of 3 weekly sessions (3-5 sets, 4-10 repetitions per session). Both groups continued bouldering training as usual throughout the intervention period. Pre- and post-intervention measures included bouldering performance, maximal dynamic finger strength, isometric finger strength (peak and average force), and rate of force development (RFD). The DFS demonstrated greater improvement in dynamic finger strength (11.5%, 3.9kg) than the CON (5.3%, 1.7kg; p = 0.075, ES = 0.90), but there were no differences between the groups in 1RM (p = 0.075, ES = 0.67), bouldering performance (p = 0.39, ES = 0.35), isometric finger strength (p = 0.42-0.56, ES = 0.20-0.22) or RFD (p = 0.30, ES = 0.46). The DFS improved dynamic (p < 0.01, ES = 1.83) and isometric peak and average (p < 0.01, ES = 0.98, and p < 0.01, ES = 0.75, respectively) finger strength, while the CON only increased dynamic finger strength (p < 0.05, ES = 0.58). None of groups improved bouldering performance or RFD (p = 0.07-0.58). In conclusion, 5weeks of DFS training improving dynamic strength to a greater extent than bouldering alone in addition to improving isometric finger strength among advanced boulderers. Isolated bouldering improved dynamic finger flexor strength, but importantly, increased finger strength (dynamic or isometric) did not improve bouldering performance.

Flexor Pronator Slide Under Local Anesthesia without a Tourniquet for Non-Ischemic Contractures of the Forearm.

Flexor Pronator Slide Under Local Anesthesia without a Tourniquet for Non-Ischemic Contractures of the Forearm.

Lesão Cortoperfurante complicada numa Enfermeira dos Cuidados de Saúde Primários: um Relato de Caso

Introduction Accidents at work resulted from sharp injuries are frequent and preventable events among health care professionals. The prevalence of secondary infection depends on several factors related to the patient itself, the health care worker and the adherence to preventive protocols. In this article, the authors pretend to present a case report of an accident involving a primary health care professional that suffered a sharp injury and, also, to alert about the significance of appropriately reporting. Case Description Woman, 54 years old, a nurse in primary care with 27 years of experience. Background history, among others, ulcerative colitis under immunosuppressive therapy. At the end of shift, she cuts herself with a contaminated scalpel blade while draining a panaritium, resulting in a superficial wound in the second finger of right hand. Notification of the occurrence was made 36 hours after the accident due to the development of local cellulitis. Later, the infection complicated with likely osteomyelitis. Two cycles of antibiotic therapy have been completed and the imagiological revaluation showed bone integrity and signs of tenosynovitis of the second finger flexors. The nurse is absent from work for 15 weeks and awaits a Physical and Rehabilitation Medicine evaluation. Discussion Health care professionals are at greater risk of accident at work, namely, of suffering sharp objects injuries. According to the literature, accidents of this nature are more frequent among female nurses and occur mainly on hands, as in the case described. Among the factors that increase the probability of these occurrences are the high workload and the number of hours worked. Standing out as a particularity of this case is the acquired immunodeficiency secondary to methotrexate therapy as the main condition of the more prolonged disease. This AW had an impact on the professional and the dynamics of the work team, with the need to adjust tasks and temporarily hire another professional. Conclusion As sharp injuries are frequent and preventable, it is important to encourage their reporting. On one hand, to protect the health of injured professionals and on the other hand, so that preventive and corrective measures can be developed. Additionally, it is relevant to know the history of the patient, of the health care professional and the mechanism of injury, to stratify the risk of associated secondary infection. In conclusion, the cooperation of Occupational Health services with other health professionals is important for the adequate management of occupational risks. KEYWORDS: occupational accidents; sharps injuries; incident reporting; family practice; occupational medicine; workplace conditions.

The effects of umbrella handle shape and grip type on muscle activation and postural variability under windy conditions

This study investigated how different shapes of umbrella handles and grip types influence muscle activation and postural variability under windy conditions. Seventeen adult participants were enrolled in this study, and different handle shapes (cylindrical, ellipsoidal, and triangular prism-shaped), grip types (four- and five-finger grip), and wind strengths were tested. Activation of the forearm and upper arm muscles was recorded using surface electromyography. Postural variability and ratings of (1) perceived difficulty of use and (2) perceived grip-posture variability were measured. The results indicated that activation of the finger flexor muscle increased under windy conditions, whereas postural variability was not affected. Weak wind (3.2–7.5 m/s) conditions caused greater perceived postural variability and activation of the wrist extensor muscle. The ellipsoidal handle shape had lower endpoint postural variability when held with a five-finger grip and also had lower perceived postural variability and difficulty compared to that with the cylindrical shape. Our findings can be used to select appropriate umbrella handle designs based on grip type and wind conditions.

Comparison of finger flexion strength and muscular recovery of male lead sport climbers across climbing classes

Background/objectiveThe purpose of this study was to compare finger flexor strength (FS), finger flexor muscle recovery (FR), and forearm circumference (FC) across three different climbing classes in male lead sport climbers. MethodsA total of 37 male lead sport climbers were classified into low (LC), intermediate (IC), and advanced classes (AC) categories according to the International Rock Climbing Research Association (IRCRA) Scale. All participants measured FS three times for both open grip (OG) and crimp grip (CG). Following FS measurement, the FR was observed immediately after the all-out training. The FC was measured twice using an inelastic tape. ResultsThe FS differed significantly across climbing classes for both grip styles and hands, regardless of dominant hand, with the higher classes showing greater FS (all, p ≤ 0.001). FR was significantly higher in AC compared to IC and LC at 5 min (all, p ≤ 0.001), 10 min (all, p ≤ 0.005) and 15 min (all, p ≤ 0.005). The FC showed significant differences with climbing classes for both forearms. ConclusionClimbing classes are associated with differences in FS, with higher class corresponding to greater FS. Similarly, climbing classes are linked to FR and FC, with higher classes being associated with faster recovery and larger FC.

An investigation of tendon strains in jersey finger injury load cases using a finite element neuromuscular human body model.

Introduction: A common hand injury in American football, rugby and basketball is the so-called jersey finger injury (JFI), in which an eccentric overextension of the distal interphalangeal joint leads to an avulsion of the connected musculus flexor digitorum profundus (FDP) tendon. In the field of automotive safety assessment, finite element (FE) neuromuscular human body models (NHBMs) have been validated and are employed to evaluate different injury types related to car crash scenarios. The goal of this study is to show, how such a model can be modified to assess JFIs by adapting the hand of an FE-NHBM for the computational analysis of tendon strains during a generalized JFI load case. Methods: A jersey finger injury criterion (JFIC) covering the injury mechanisms of tendon straining and avulsion was defined based on biomechanical experiments found in the literature. The hand of the Total Human Model for Safety (THUMS) version 3.0 was combined with the musculature of THUMS version 5.03 to create a model with appropriate finger mobility. Muscle routing paths of FDP and musculus flexor digitorum superficialis (FDS) as well as tendon material parameters were optimized using literature data. A simplified JFI load case was simulated as the gripping of a cylindrical rod with finger flexor activation levels between 0% and 100%, which was then retracted with the velocity of a sprinting college football player to forcefully open the closed hand. Results: The optimization of the muscle routing node positions and tendon material parameters yielded good results with minimum normalized mean absolute error values of 0.79% and 7.16% respectively. Tendon avulsion injuries were detected in the middle and little finger for muscle activation levels of 80% and above, while no tendon or muscle strain injuries of any kind occurred. Discussion: The presented work outlines the steps necessary to adapt the hand model of a FE-NHBM for the assessment of JFIs using a newly defined injury criterion called the JFIC. The injury assessment results are in good agreement with documented JFI symptoms. At the same time, the need to rethink commonly asserted paradigms concerning the choice of muscle material parameters is highlighted.

Discrimination of finger movements by magnetomyography with optically pumped magnetometers

Optically pumped magnetometers (OPM) are quantum sensors that offer new possibilities to measure biomagnetic signals. Compared to the current standard surface electromyography (EMG), in magnetomyography (MMG), OPM sensors offer the advantage of contactless measurements of muscle activity. However, little is known about the relative performance of OPM-MMG and EMG, e.g. in their ability to detect and classify finger movements. To address this in a proof-of-principle study, we recorded simultaneous OPM-MMG and EMG of finger flexor muscles for the discrimination of individual finger movements on a single human participant. Using a deep learning model for movement classification, we found that both sensor modalities were able to discriminate finger movements with above 89% accuracy. Furthermore, model predictions for the two sensor modalities showed high agreement in movement detection (85% agreement; Cohen’s kappa: 0.45). Our findings show that OPM sensors can be employed for contactless discrimination of finger movements and incentivize future applications of OPM in magnetomyography.

Comparative study of trimming and resection of diseased finger superficial flexor tendons in gouty carpal tunnel syndrome

BackgroundHyperuricemia can lead to synovial hyperplasia in the wrist. In severe cases, it can lead to the deposition of gouty stone in the carpal tunnel, resulting in increased pressure in the carpal tunnel and compression of the median nerve to cause carpal tunnel syndrome (CTS), which is called gouty carpal tunnel syndrome (GCTS). As for the surgical treatment of gouty carpal tunnel syndrome, scholars have different opinions on whether it is necessary to remove the superficial flexor tendon. The purpose of this study was to compare the clinical efficacy of trimming and resection of the diseased superficial flexor tendon in the treatment of gouty carpal tunnel syndrome.MethodsClinical data were collected from May 2016 to July 2021 from 10 patients (13 affected wrists) diagnosed with gouty carpal tunnel syndrome and classified into two groups according to the surgical modality: the diseased portion of the gout-eroded superficial finger tendon was trimmed in 9 wrists, and the diseased superficial finger flexor tendon was excised in 4 wrists. Values related to flexion and extension functions, 2-PD, DASH, BCTQ, VAS and recurrence in the affected fingers were compared between the two groups as well as before and after surgery in each group.ResultsAll affected limbs used were cleared of gouty stones, finger numbness improved, no skin necrosis occurred, and all incisions healed at stage I. At follow-up (13.58 ± 5.53 months), there was no significant difference between groups in flexion and extension function, 2-PD, DASH, BCTQ, and VAS with respect to the affected fingers, and patients in both groups improved significantly before and after surgery. Treatment of only one wrist involved trimming to remove lesion-affected portions of tendon, which reappeared 1 year after surgery, and there was one case of poor recovery from greater piriformis muscle atrophy in both procedures.ConclusionRegarding surgical treatment of patients with gouty carpal tunnel syndrome in which the gouty stone has invaded the superficial flexor tendons of the fingers, the diseased superficial flexor tendons can be selectively excised, and the postoperative mobility of the affected fingers may not be impaired.

Handedness, Bilateral, and Interdigit Strength Asymmetries in Male Climbers.

To determine whether there are bilateral and interdigit differences in the maximal force production of experienced climbers and whether these differences are mediated by ability level or preferred style of climbing. Thirty-six male climbers (age 30 [9.4]y) took part in a single-session trial to test their maximal force production on both hands. The tests included a one-arm maximal isometric finger flexor strength test (MIFS) and a one-arm individual MIFS. Bilateral differences were analyzed by strongest hand (defined as the hand that produced the highest MIFS value) and dominance (defined as the writing hand). A pairwise t test found thatMIFS was significantly greater for the strongest hand (mean difference = 4.1%, 95%CI, -0.052 to 0.029, P < .001), with handedness explaining 89% of the variation. A 2-way mixed-model analysis of variance determined that there were no interactions between preferred style (bouldering or sport climbing) and MIFS or betweenability level (advanced or elite) and MIFS. Climbers have significant finger flexor strength bilateral asymmetries between their strongest and weakest hand. Moreover, when dominance is controlled, this difference in strength is present, with the dominant hand producing more force. Neither preferred style of climbing nor the ability level of the climbers could explain these asymmetries. As such, practitioners should consider regularly monitoring unilateral strength, aiming to minimize the likelihood of large bilateral asymmetry occurring.

Development of Wearable Finger Prosthesis with Pneumatic Actuator for Patients with Partial Amputations

As the number of patients with amputations increases, research on assistive devices such as prosthetic limbs is actively being conducted. However, the development of assistive devices for patients with partial amputations is insufficient. In this study, we developed a finger prosthesis for patients with partial amputations. The design and mathematical modeling of the prosthesis are briefly presented. A pneumatic actuator, based on the McKibben muscle design, was employed to drive the finger prosthesis. We characterized the relationship between the actuator’s force and axial length changes with varying pressure. An empirical model derived from conventional mathematical modeling of force and axis length changes was proposed and compared with experimental data, and the error was measured to be between about 3% and 13%. In order to control the actuator using an electromyography (EMG) signal, an electrode was attached to the user’s finger flexors. The EMG signal was measured in relation to the actual gripping force and was provided with visual feedback, and the magnitude of the signal was evaluated using root mean square (RMS). Depending on the evaluated EMG signal magnitude, the pressure of the actuator was continuously adjusted. The pneumatic pressure was adjusted between 100 kPa and 250 kPa, and the gripping force of the finger prosthesis ranged from about 0.7 N to 6.5 N. The stiffness of the prosthesis can be varied using the SMA spring. The SMA spring is switched to a fully austenite state at 50 °C through PID control, and when the finger prosthesis is bent to a 90° angle, it can provide approximately 1.2 N of assistance force. Finally, the functional evaluation of the finger prosthesis was performed through a pinch grip test of eight movements.

Inclusion body myositis accompanied with T-cell large granular lymphocyte leukemia

Inclusion body myositis (IBM) is a late-onset myopathy that manifests as distinct muscle weakness in the quadriceps, finger flexors, and ankle dorsiflexors. T-cell large granular lymphocyte (T-LGL) leukemia is a late-onset clonal disorder of CD8+ cytotoxic T-cells that is often accompanied by autoimmune diseases. To date, the association between IBM and T-LGL leukemia has been infrequently reported. Here, we report a case of a patient with T-LGL leukemia who developed IBM, along with in-depth laboratory, electrophysiological, and pathologic findings.

Neuromechanics of finger hangs with arm lock-offs: analyzing joint moments and muscle activations to improve practice guidelines for climbing.

Climbing imposes substantial demands on the upper limbs and understanding the mechanical loads experienced by the joints during climbing movements is crucial for injury prevention and optimizing training protocols. This study aimed to quantify and compare upper limb joint loads and muscle activations during isometric finger hanging exercises with different arm lock-off positions. Seventeen recreational climbers performed six finger dead hangs with arm lock-offs at 90° and 135° of elbow flexion, as well as arms fully extended. Upper limb joint moments were calculated using personalized models in OpenSim, based on three-dimensional motion capture data and forces measured on an instrumented hang board. Muscle activations of upper limb muscles were recorded with surface electromyography electrodes. Results revealed that the shoulder exhibited higher flexion moments during arm lock-offs at 90° compared to full extension (p = 0.006). The adduction moment was higher at 135° and 90° compared to full extension (p < 0.001), as well as the rotation moments (p < 0.001). The elbows exhibited increasing flexion moments with the increase in the arm lock-off angle (p < 0.001). Muscle activations varied across conditions for biceps brachii (p < 0.001), trapezius (p < 0.001), and latissimus dorsi, except for the finger flexors (p = 0.15). Our findings indicate that isometric finger dead hangs with arms fully extended are effective for training forearm force capacities while minimizing stress on the elbow and shoulder joints. These findings have important implications for injury prevention and optimizing training strategies in climbing.

Acute Carpal Tunnel Syndrome from Horseshoe Abscess

Case: A 53-year-old man presented with a puncture wound to his right thumb, resulting in a horseshoe abscess, its infectious clinical picture muddled by dense paresthesias from the ensuing acute carpal tunnel syndrome. He was treated with irrigation and debridement of the thumb and small finger flexor tendon sheaths, carpal tunnel release, and bootlacing and dermal substitute application to the proximal forearm with eventual split-thickness skin grafting. Conclusion: Although a horseshoe abscess resulting in acute carpal tunnel syndrome is a rare entity unquantified in the literature, the treating orthopaedic surgeon should be aware of its association and initiate appropriate treatment accordingly.

Comparing low volume of blood flow restricted to high-intensity resistance training of the finger flexors to maintain climbing-specific strength and endurance: a crossover study.

It is acknowledged that training during recovery periods after injury involves reducing both volume and intensity, often resulting in losses of sport-specific fitness. Therefore, this study aimed to compare the effects of high-intensity training (HIT) and low-intensity training with blood flow restriction (LIT + BFR) of the finger flexors in order to preserve climbing-specific strength and endurance. In a crossover design, thirteen intermediate climbers completed two 5-week periods of isometric finger flexors training on a hangboard. The trainings consisted of ten LIT + BFR (30% of max) or HIT sessions (60% of max without BFR) and were undertaken in a randomized order. The training session consisted of 6 unilateral sets of 1 min intermittent hanging at a 7:3 work relief ratio for both hands. Maximal voluntary contraction (MVC), force impulse from the 4 min all out test (W), critical force (CF) and force impulse above the critical force (W') of the finger flexors were assessed before, after the first, and after the second training period, using a climbing-specific dynamometer. Forearm muscle oxidative capacity was estimated from an occlusion test using near-infrared spectroscopy at the same time points. Both training methods led to maintaining strength and endurance indicators, however, no interaction (P > 0.05) was found between the training methods for any strength or endurance variable. A significant increase (P = 0.002) was found for W, primarily driven by the HIT group (pretest-25078 ± 7584 N.s, post-test-27327 ± 8051 N.s, P = 0.012, Cohen's d = 0.29). There were no significant (P > 0.05) pre- post-test changes for MVC (HIT: Cohen's d = 0.13; LIT + BFR: Cohen's d = -0.10), CF (HIT: Cohen's d = 0.36; LIT + BFR = 0.05), W` (HIT: Cohen's d = -0.03, LIT + BFR = 0.12), and forearm muscle oxidative capacity (HIT: Cohen's d = -0.23; LIT + BFR: Cohen's d = -0.07). Low volume of BFR and HIT led to similar results, maintaining climbing-specific strength and endurance in lower grade and intermediate climbers. It appears that using BFR training may be an alternative approach after finger injury as low mechanical impact occurs during training.

Validity of the Entralpi force plate in the assessment of finger flexor performance metrics in rock climbers

ABSTRACT This study assessed the validity of the Entralpi force plate in the assessment of finger flexor performance in rock climbers. In addition to a static force evaluation, peak force, peak impulse, and total impulse were measured during 30 all-out performance trials by 15 participants, in which force during the trials was recorded simultaneously by the Entralpi and a Pasco force plate. Agreement between devices was assessed by a variety of statistical analyses, including intraclass correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman analyses. The static force evaluation showed a mean relative error of 0.41% and excellent day-to-day reliability (ICC = 1; CV = 0.03%). Peak force, peak impulse, and total impulse from the performance trials demonstrated strong agreement (ICC ≥ 0.991, CV ≤ 1.9%, Bland-Altman mean bias ≤ 0.5%). These results illustrate that the Entralpi force plate provides accurate and reliable data for rock climbing related tasks at an affordable cost.

Extended source analysis of movement related potentials (MRPs) for self-paced hand and foot movements demonstrates opposing cerebral and cerebellar laterality: a preliminary study

The cerebellum is known to have extensive reciprocal connectivity with the cerebral cortex, including with prefrontal and posterior parietal cortex, which play an important role on the planning and execution of voluntary movement. In the present article we report an exploratory non-invasive electrophysiological study of the activity of the cerebellum and cerebrum during voluntary finger and foot movements. In a sample of five healthy adult subjects, we recorded EEG and the electro-cerebellogram (ECeG) with a 10% cerebellar extension montage during voluntary left and right index finger and foot movements. EMG was recorded from finger extensors and flexors and from the tibialis anterior and soleus muscles and was used to generate triggers for movement related averaging (−2000 to +2000 ms). Source analysis was conducted over five epochs defined relative to EMG onset: whole epoch (−1000 to +1000 ms), pre-move 1000 (−1000 to 0 ms), pre-move 500 (−500 to 0 ms), post-move 500 (0 to +500 ms) and post-move 1000 (0 to +1000 ms). This yielded a total of 123 cerebral and 65 cerebellar dipole clusters from across all epochs, including the pre-movement epochs, which were then subject to statistical analysis. These demonstrated predominantly contralateral dominance for the cerebral clusters, but predominantly ipsilateral dominance for the cerebellar clusters. In addition, both cerebral and cerebellar clusters showed evidence of a somatotopic gradient, medially (X-axis) for the cerebral clusters, and medially and dorso-ventrally (Z-axis) for the cerebellar clusters. These findings support the value of recording cerebellar ECeG and demonstrate its potential to contribute to understanding cerebellar function.

Biomechanical Investigation of Methods of Grasping a Trombone: A Pilot Study

Trombonists, like other musicians, are at risk for developing use-related musculoskeletal symptoms. This study investigated an ergonomic aid for playing the trombone, the Neotech Trombone GripTM, which assists a trombonist’s left hand in supporting the instrument. The objective of the study was to investigate effects of this device on the left upper extremity while playing the trombone in comparison to the standard, unaided method of grasping it. Seven trombone players used the grip for two weeks prior to providing objective and subjective data in a laboratory environment. They played a scale and a piece of their choice under four conditions: sitting or standing with or without the device on their trombone. While playing, muscle activity in the trapezius, anterior deltoid, middle deltoid, extrinsic finger flexor, and extrinsic finger extensor muscle groups on the left side of the body were collected. Perceptions on the device using a survey were also assessed. Results indicated a consistent decrease in muscle activity in the finger flexor group when using the device. Smaller, less consistent effects were seen in activity in the trapezius (decrease), finger extensor group (increase), and anterior deltoid (increase) muscles, while using the device. Effects were more pronounced in players with smaller hands (among the group of participants). Most players subjectively found the device beneficial and all would recommend it to other players.

РЕЗУЛЬТАТЫ ХИРУРГИЧЕСКОГО ЛЕЧЕНИЯ ЗАСТАРЕЛЫХ ПОВРЕЖДЕНИЙ СУХОЖИЛИЙ СГИБАТЕЛЕЙ ПАЛЬЦЕВ КИСТИ В КОСТНО-ФИБРОЗНЫХ КАНАЛАХ

Background. Restoration of finger flexor tendons in fibro-osseous canals in the long term after injury is a difficult task due to scarring blockage and the impossibility of early active rehabilitation. Therefore, it is important to develop methods for durable tendon reconstruction that can provide early rehabilitation of patients without the risk of rupture of the suture zone. Aim. To evaluate the clinical effectiveness of surgeries on the flexor tendons of fingers in case of chronic injuries in fibro-osseous canals with the creation of strong connections in the sutured zone. Material and methods. The study included 66 patients with chronic injuries of 104 flexor tendons in fibro-osseous canals of the fingers. The main group consisted of 29 patients who underwent restoration of 47 tendons using new methods within 3 to 11 weeks after injury: subgroup A included 23 cases of reconstruction of the deep flexor tendon with a hidden transosseous suture in zone I; subgroup B included 24 sutures with isolation with dissected polymeric tube in zone II. Control group included 37 patients with tendon injuries on 49 fingers within fibro-osseous canals with injury term from 3 weeks to 30 years who underwent classical surgeries: secondary flexor digitorum profundus suture on 31 fingers, 2-stage tendoplasty – on 13, distal phalanx tenodesis – on 4 and reinsertion by Bunnell – on 1 finger. Also, as a control, 8 fingers were evaluated in 7 patients of the main group on which 4 secondary sutures, 2 tendoplasties and 2 tenodeses were performed. Finger function was determined by J.W. Strickland before 3, 6 months and 1 year after surgery, qualitative parameters were analyzed using two-tailed Fisher's exact test. Hand function was evaluated using the DASH questionnaire before surgery and 1 year later, the significance of differences was checked using the Mann-Whitney U-test. Results. The use of durable tendon reconstruction methods in patients of the main group enables to obtain results on average in 3 months similar to the results of 2-stage tendoplasty 10-12 months after the start of treatment in the control group. The results of reinsertion with a hidden transosseous suture and suture with temporary isolation with dissected polymer tubes did not differ significantly in terms of the degree of range of motion recovery and hand function assessment by patients. Conclusions. The developed methods showed better results in restoring the function of the fingers in comparison with classical surgeries. A strong tendon connection combined with an early start of movement increases the number of good and excellent functional outcomes and ensures patients’ satisfaction with treatment results.

Validation of the Efficacy of Ultrasound Speckle Tracking in Measuring Tendon Gliding After Finger Flexor Tendon Repair.

Restricted tendon gliding is commonly observed in patients after finger flexor tendon (FFT) repair. The study described here was aimed at quantifying the amount of FFT gliding to evaluate the recovery of post-operative tendons using a 2-D radiofrequency (RF)-based ultrasound speckle tracking algorithm (UST). Ex vivo uniaxial tensile testing of porcine flexor tendons and in vivo isometric testing of human FFT were implemented to verify the efficacy of UST beforehand. The verified UST was then applied to the patients after FFT repair to compare tendon gliding between affected and healthy sides and to investigate its correlation with the joint range of motion (ROM). Excellent validity was confirmed with the average R2 value of 0.98, mean absolute error of 0.15 ± 0.08 mm and mean absolute percentage error of 5.19 ± 2.43% between results from UST and ex vivo testing. The test-retest reliability was verified with good agreement of ICC (0.90). The affected side exhibited less gliding (p=0.001) and smaller active ROM (p=0.002) than the healthy side. Meanwhile, a significant correlation between tendon gliding and passive ROM was found only on the healthy side (ρ=0.711, p=0.009). The present study provides a promising protocol to evaluate post-operative tendon recovery by quantifying the amount of FFT gliding with a validated UST. FFT gliding in patients with different levels of ROM restriction should be further explored for categorizing the severity of tendon adhesion.