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Flexor Digitorum Superficialis and Flexor Digitorum Profundus Tendon Lengthening in Adults With Acquired Spasticity of the Hand

March 01, 2019

Contributors: Alan J Micev, MD; Victor Hoang, DO; Victor Hoang, DO

This video shows a 77-year-old right hand--dominant man with a clenched fist deformity of his right long, ring, and little fingers. The patient has a history of stroke and underwent a prolonged course of occupational therapy, including dynamic and static splinting. He continued to have difficulty performing hygiene tasks and failed extensive nonsurgical treatment modalities. The patient has obvious extrinsic flexor tendon contractures and substantially improved digital extension with the wrist in a flexed position. A longitudinal incision is made in the forearm ulnar to the palmaris longus tendon. Flexor digitorum superficialis and flexor digitorum profundus tendon lengthening is performed at the musculotendinous junction. Adults with acquired spasticity of the hand may present with extrinsic digital flexion contractures. The goal of surgical management is to alleviate hygienic problems, recurrent nail bed infections, and painful joint subluxation. Spastic hand deformity is successfully managed via flexor digitorum superficialis and flexor digitorum profundus tendon lengthening.

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