TENDINOUS INTERCONNECTIONS OF THE HAND FLEXORS

Abstract

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The thumb has one (flexor pollicis longus), while the other fingers have 2 flexor tendons (flexor digitorum superficialis and profundus). Interconnections of these tendons occur in about 20% of the general population and could be tendinous or tendon sheath connection of variable size. The level of the interconnection may be different: in the hand, wrist or forearm. An interconnection between flexor pollicis longus and flexor digitorum profundus is named Linburg-Comstock variation. This variation often involves the flexor digitorum profundus of the index finger and on clinical examination is characterized by a simultaneous flexion of the forefinger during the active flexion of the thumb. The tendinous interconnections between flexor digitorum superficialis and flexor digitorum profundus are also frequent, especially between flexor digitorum superficialis of the little finger and adjacent fingers. Presence of the tendinous interconnections is asympthomatic in most of cases but sometimes they may limit precise movements of the involved fingers, may cause career-threatening disabilities or could complicate some hand injuries. In some patients tendinous interconnections can cause pain and swelling in the palmar aspect of the hand and wrist, tenosynovitis or carpal tunnel syndrome.