Ultrasonographic Assessment of Long Finger Tendon Excursion in Zone V During Passive and Active Tendon Gliding Exercises
Purpose
Cadaver and in vivo studies report variable results for tendon excursion during active and passive hand movements. The purpose of this study was to measure long finger flexor digitorum profundus (FDP) tendon excursion during active and passive movement using high-resolution ultrasound images.
Methods
The FDP tendon excursion was measured at the wrist level in 10 healthy subjects during full tip-to-palm active and passive flexion of the fingers. Passive movement was performed 2 ways: (1) straight to full fist: passive flexion starting at the metacarpophalangeal joint, followed by proximal interphalangeal and distal interphalangeal joint flexion; and (2) hook to full fist: passive flexion starting at the distal interphalangeal joint, followed by proximal interphalangeal and metacarpophalangeal joint flexion. Tendon excursion was measured using an in-house-developed, frame-to-frame analysis of high-resolution ultrasound images.
Results
Median FDP excursion was 24.3 mm, 14.0 mm, and 13.6 mm for active fist, straight to full fist, and hook to full fist movements, respectively. Tendon excursions during active movements was significantly larger than excursions during passive movements (p = .005). The adjusted median tendon excursion was 12.7 mm/100°, 7.5 mm/100°, and 7.4 mm/100° for active fist, straight to full fist, and hook to full fist movements, respectively. Adjusted tendon excursions during active movement were significantly larger than those achieved during passive straight to full fist movement). Adjusted tendon excursions during straight to full fist movements were significantly larger than those achieved during passive hook to full fist movement.
Conclusions
Active motion produced 74% and 79% increases in excursions compared to both passive motions in healthy controls. The study results can serve as a reference for evaluating excursions in patients with tendon pathology, including those who have had tendon repair and reconstruction.
Key words: Early active mobilization, early controlled mobilization, rehabilitation, tendon excursion, ultrasound
This study was supported by a 2009 to 2011 Nuts-Ohra Grant. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
The authors gratefully acknowledge W.B. Vletter and all laboratory assistants from the Department of Cardiology of the Erasmus Medical Center, Rotterdam, for providing scanning facilities. We gratefully acknowledge Professor H. J. Stam, MD, PhD, for his help in editing this paper. We also kindly acknowledge J.N.M. Soeters, Department of Rehabilitation Medicine, for his comments and H.L.D. Horemans, PhD, for his assistance with video analyses. Finally, we acknowledge all study participants.
PII: S0363-5023(10)00051-1
doi:10.1016/j.jhsa.2010.01.010
© 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
