Developing a non-invasive method for in vivo monitoring of forearm flexor tendon excursions during rehabilitation following surgical tendon repair

Abstract

Background: An injury to the wrist and hand can impact different anatomical structures. Any damage or cut to the flexor tendons can leave a devastating impact if not treated well and can therefore compromise our daily physical activities. Surgery and rehabilitation are two factors contributing to recovery post flexor tendon repair.

Method: A comprehensive literature search was conducted identifying the pertinent factors that can contribute towards tendon recovery. The methodology of the study focuses on measurement of flexor tendon excursion of flexor pollicis longus, flexor digitorum superficialis (index, middle, ring and little finger), flexor carpi ulnaris and flexor carpi radialis tendons on healthy volunteers. The measurements were carried out twice on the same subjects on two different days. The tendon excursions were viewed under diagnostic 2D ultrasound, in three positions- finger flexion to 90 degree, whilst making a fist and on gripping JAMAR at 5 kgf.

Results: The ultrasound images of the tendons showed anatomical variability. Variability was also noted in the distance from the wrist crease to the muscle tendon junction at rest. The tendon excursions varied in all the participants and showed higher values on gripping JAMAR at 5kgf (49.03N). It also showed that the maximal tendon excursion per degree of movement was noticed in FDS(I) followed by FCU and FDS(M) tendons. With the use of JAMAR, it showed a maximal tendon excursion per Newton load of force in FPL followed by FDS(M) and FDS(R) tendons.

Conclusion: The developed method and data would assist in planning a rehabilitation regime for the patients post flexor tendon repair. Future research is required to implement this experimental protocol in patients with flexor tendon repair.