Segmental lengthening of the flexor carpi radialis and digitorum tendon

The radial flexor tendon and flexor tendon segmental extension are used for the treatment of wrist and finger flexion deformities. The most common malformation of upper extremity paralysis is the wrist and finger flexion deformity. These malformations are often associated with forearm pronation, elbow flexion, and thumb palm malformation. Zancolli, Goldner, and Swanson divide wrist and finger flexion deformities into three types. Type I is when the wrist flexes less than 20° and the fingers can be actively extended. This is a fairly light deformity of the hand, when the hand has the function of grasping and loosening, but when the finger is fully extended, the wrist joint cannot be stretched. In this case, joint ulnar flexor tendon stenosis and finger flexor lengthening should be considered. The extended part is preferably at the junction of muscle and tendon. Flexor slip can also be chosen. Type II is that the finger can only be actively extended when the wrist flexes more than 20°. This type can be further divided into two subtypes. When the type IIA is flexed, the wrist can be stretched at will, indicating that the extensor muscle of the wrist is viable and the flexor of the finger is not severely paralyzed. Type IIB is that when the finger is flexed, the sick child can not stretch the wrist joint at will, indicating that the wrist joint extensor muscle is paralyzed, and it is necessary to strengthen the muscle strength to improve the function. In type IIB, the flexor extension of the fingers should be considered, and the tendon displacement should be combined to enhance the stretching function of the fingers or wrist joints. The classic method of displacement is to shift the ulnar wrist flexor to the short extensor tendon of the temporal wrist to improve the forearm supination, wrist extension and finger flexion (grip) function. If the finger is straight (relaxed), the force is very weak, then it is preferred to shift to the total extensor muscle. Preoperative electromyography helps determine whether the muscle is viable during that period, whether it is grasping or relaxing. Type III has severe flexion deformity, and it is not possible to actively extend or extend the wrist even from the beginning of extreme flexion. The feeling of the hand is usually poor. Surgery is not likely to improve function, but it helps to improve personal hygiene. The wrist flexion tendon can be severed, and the superficial flexor tendon is displaced to the deep flexor tendon. Wrist joint fusion and carpalectomy can improve the appearance of these severe deformities. Treatment of diseases: finger flexor tenosynovitis Indication The temporal flexor tendon and flexor tendon segmental extension are applied to wrist and finger flexion deformities. Preoperative preparation Regular preoperative examination. Surgical procedure 1. Start with a 3cm proximal to the lateral of the forearm palm, and make a 6cm long curved palmar incision to the proximal side. The temporal flexor tendon was determined, and the muscle tendon junction was separated proximally and then reached the proximal abdomen. The distal part of the muscle abdomen is surrounded by the aponeurosis, and the aponeurosis is thickened distally to form its own tendon. A transverse incision is made on the proximal aponeurosis of the muscle tendon junction to extend the muscle tendon unit but retain its continuity. To completely expose the muscles in a circular shape, and cut the aponeurosis in a circular shape, cut the aponeurosis but do not cut the muscles. It is very important to ensure that the diaphragm is cut transversely without leaving any intact tendons, otherwise the muscle tendon unit cannot be extended. After cutting on the diaphragm, place the wrist in the dorsal extension. As the muscle lengthens, the aponeurotic incision will widen, but the entire muscle tendon unit remains intact. It is feasible to make 2 to 3 stages of incision and extension. 2. In addition to the radial flexor tendon, other muscle tendon units may contract. The longissimus muscle often collapses and needs to be extended in the same way. Through the same incision, the flexor of the finger can also be extended in the same way. If the flexor of the finger flexes, first extend the finger flexor, and then extend the deep flexor.

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