On the variations of the muscle flexor digitorum brevis: anatomical insight / Variaciones del músculo flexor corto de los dedos: experiencias de anatomía

Flexor digitorum brevis, an intrinsic muscle of the sole of the foot, is stated as one of the muscles that shows frequent anatomical variations. Its most commonly reported anomaly is the absence of tendon to the little toe. From a clinical standpoint of view, flexor digitorum brevis musculocutanous flap is used in the reconstruction of the heel pad and flexor digitorum brevis tendon transfer is employed in the correction of flexible claw and hammer toe deformities. Despite its significance little is known regarding the variations of this muscle in Sri Lankans. Hence, the goal of this study was to elucidate the incidence and morphological features of this muscle in an adult Sri Lankan population. A total of one hundred and thirty five apparently healthy human feet were dissected and studied for the morphological features of the flexor digitorum brevis muscle. The incidence of the absent fourth tendon of the flexor digitorum brevis in the present study was found to be 71.85 percent. In all cases, when absent, it was missing bilaterally. The results of the present study further highlight the anatomical variations of the flexor digitorum brevis muscle. A sound knowledge about the anatomical variations of flexor digitorum brevis will facilitate the outcome of surgical as well as diagnostic imaging techniques of the foot. Furthermore, understanding muscle architecture of the foot may assist in the design of prosthesis and analysis of foot function.

El músculo flexor corto de los dedos, es un músculo intrínseco de la planta del pie que frecuentemente presenta variaciones anatómicas. La variación más frecuente es la ausencia de tendón destinado al dedo mínimo. Desde el punto de vista clínico se utilizan colgajos musculocutáneos del músculo flexor corto de los dedos para la reconstrucción de la región subcalcánea. Además, el tendón del músculo es usado para corregir deformidades de garra y martillo de los dedos del pie. A pesar de su importancia, es escasa la información acerca de este músculo en la población adulta de Sri Lanka.Fueron disecados 135 pies humanos aparentemente sanos analizándose sus características morfológicas. Se determinó que un 71,85 por ciento el tendón para el quinto dedo del músculo flexor corto de los dedos estaba ausente. En todos los casos, ésta se presentaba bilateralmente. El estudio señala la importancia de tener un cabal conocimiento acerca de las variaciones anatómicas del músculo flexor corto de los dedos, para facilitar tanto las técnicas quirúrgicas, como el diagnostico a través de imagenlogía del pie. Además, un buen conocimiento de la arquitectura muscular del pie puede ayudar en el diseño de prótesis y en el análisis de la función del pie.

Factores de riesgo asociados a tenosinovitisestenosante: estudio de casos y controles / Risk factors associated with trigger finger: case-control study

OBJECTIVE: We undertook this study to identify risk factors in our population associated with trigger finger. The study was conducted at the Instituto Mexicano del Seguro Social, UMAE 21, Monterrey, Nuevo Leon, Mexico. METHODS: This was a case-control, retrospective, and observational study. There were 250 patients in each group. For cases, patients who were operated on for trigger finger from March 2006 to August 2006 were included. Controls included patients admitted to the Emergency Department with hand injuries that fulfilled the selection criteria. Risk factors analyzed were diabetes, hypertension, smoking, sex, age, weight, and 19 different occupations. RESULTS: Mean age of the cases was 52 years (SE +/- 14.19 years) with a median and mode of 53 years. The right hand was the most common with the middle, thumb, ring, index and little fingers, respectively. A significant statistical relationship was found: females (OR 7.57, 95% CI 5.07-11.31); diabetes (OR 3.72, 95% CI 2.43-5.70); obesity (OR 1.49, 95% CI 1.02-2.19). With regard to occupation, a statistical relationship was found: homemaker (OR 2.44, 95% CI 1.62-3.69); seamstress (OR 4.8, 95% CI 1.3-21.6); and secretary (OR 2.74, 95% CI 1.38-5.52). CONCLUSIONS: Trigger finger is a common pathology in our population and is more frequent in women >53 years old. It may be related to diabetes, body mass index (obesity) and certain occupations such as secretary, seamstress and homemaker.