Khine Oo
School of Medicine
Poster 1 A cadaveric study on the anatomical variation of the Flexor Digitorum Profundus ( FDP ) and the average position of the proximal tenomuscular junction ( PTMJ ), with particular relevance to deep lacerations injuries of the forearm
Deep laceration injuries of the forearm will most likely involve the FDP however , surgical management may vary depending on whether the tendinous or muscular portion has been affected . This can be differentiated at the PTMJ , the location of which varies between the four FDP tendons . Thus , having an understanding of the average position of the PTMJ can allow surgeons to determine the location , management and overall prognosis of the injury . Four fresh frozen cadaveric forearms were dissected and the PTMJ identified as the most proximal point at which tendon and muscle began to merge . The mean apparent FDP length , measured between the medial epicondyle and proximal carpal tunnel , equalled 242.8 ± 2.42 mm and the mean PTMJ for the 2nd , 3rd , 4th and 5th tendons are as follows : 96.6 ± 11.4 ; 98.2 ± 6.01 ; 102.7 ± 8.2 and 84.6 ± 21.1 mm , respectively . The PTMJ was represented as a percentage of the apparent FDP length ; as follows (%): 39.8 ; 40.4 ; 42.3 and 34.8 , respectively . Thus , the average PTMJ was found to be present at approximately 39.2 % ( or 2 / 5 ) of the apparent FDP length . This can be clinically applied in the examination of suspected deep forearm laceration injuries .
Poster 2 A cadaveric study on the anatomy of the Flexor Digitorum Profundus , the biomechanical basis of the Quadriga Effect , and potential methods of examination
The Flexor Digitorum Profundus ( FDP ) is conjoined at the muscle belly , common tendinous intersection , carpal tunnel and within the hand . Thus , flexion of one digit leads to passive flexion of the neighbouring three digits at various degrees . This is known as the Quadriga Effect ( QE ), which compares the action of the FDP to the Roman Quadriga ; a chariot drawn by four horses . The QE can predispose postoperative contracture deformities , therefore , understanding the anatomy and biomechanics of the FDP , in conjunction with clinical examination may allow surgeons to determine the extent of the Quadriga and the likely postoperative outcome of flexor tendon injuries . Four fresh-frozen cadaveric forearms were dissected and the following data was obtained : apparent FDP length , tendon width and the number of Oo-Thomas Tendonelles ( OTT ). A custom-made tensioning apparatus was used to measure individual tendon excursion . Variation was noted within the FDP tenomusculature . Biomechanical data revealed the 2nd FDP tendon as being most independent , whilst the 4th and 5th tendons had the greatest effect on collateral tendon excursion . The 4th FDP tendon appears to act as the epicentre of the Quadriga and therefore , is most likely to result in postoperative contracture deformities with concomitant involvement of adjacent digits .
Postgraduate Conference 2020 Page 32