ABSTRACT
After finger amputations, spontaneous adhesions of the resected profundus tendon may occur in the finger stump or palm. Because of the normal interconnections of the profundus tendons, such adhesions can block the excursion of the profundus tendons to intact fingers, resulting in the quadriga syndrome, or profundus tendon blockage. This causes a decrease in the power and range of movement of the terminal joints of the uninjured fingers when they are fully flexed. Three degrees of severity of this weakness are described. The findings and results of surgery in 20 patients demonstrate that the condition is surgically correctable by release of the adherent profundus tendon of the amputated digit. Full active flexion and extension of the intact fingers in the early postoperative period after primary amputation should prevent them from developing profundus tendon blockage.
Subject(s)
Amputation Stumps , Fingers/surgery , Postoperative Complications/etiology , Tendons/pathology , Adult , Aged , Female , Humans , Male , Middle Aged , Postoperative Complications/pathology , Postoperative Complications/surgery , Tissue Adhesions/pathologyABSTRACT
A clinical study of hand strength and complications in 41 patients with a transmetacarpal amputation of the index finger found that the average prehension strength was reduced by 20% and stability of grip by almost 50%. Tendon transfers or other operative modifications did not affect the results. The most disabling complication, hyperesthesia, or painful sensitivity to light touch, in the thumb--long-finger web was present in 59% of patients and interfered with hand function in 37%.
