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A comparative study of tendinous interconnection in the forearm and hand of human cadavers and live subjects

Stephens, Shiby 2013. A comparative study of tendinous interconnection in the forearm and hand of human cadavers and live subjects. MPhil Thesis, Cardiff University.
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Abstract

Certain complex hand functions such as playing musical instruments, buttoning and writing require the action of the long flexor tendons. Repeated movements of these tendons cause inflammatory changes resulting in an increase in the Tendon Cross Sectional Area (TCSA), and, subsequently, tendinous interconnections (occurs in approximately 20% of the general population, commonly between the flexor pollicis longus [FPL] and index finger flexor digitorum profundus [FDP] - Linburg-Comstock syndrome). Coupled with an anatomically congested space at the wrist, such interconnections may compress the median nerve resulting in carpal tunnel syndrome. This study evaluated the prevalence of tendinous interconnection amongst 200 medical students at Cardiff University by a series of structured hand movements (n=12) in controlled setting. The findings were corroborated using Ultrasound Scan (USS) (n=4) and Magnetic Resonance Imaging (MRI) (n=1). The muscle mass, fibre length, density, angle of pennation and tendon length were ascertained by studying hands and forearms (n=30) of embalmed human cadavers. The data was used to determine the Physiological Cross Sectional Area (PCSA) and calculate the relation between PCSA and TCSA. Simple linear regression established the direct relation of PCSA to TCSA, muscle mass and tendon length. A direct relation between the TCSA of FPL and index finger FDP was identified. The cross sectional area of the median nerve increases as it traverses the carpal tunnel. The PCSA had no bearing on density and angle of pennation. USS was found to be more dynamic and sensitive than MRI in identifying tendinous and tenosynovial interconnections, as the tenosynovial interconnections <1 mm thick could be recognised. The study also (i) identified a lower percentage of tendinous interconnection (compared to the literature) in a randomly selected group of individuals, (ii) detected the limitation of photograpic measurements to study angles of finger movements and (iii) highlighted the disadvantage of calculating PCSA in cadavers.

Item Type: Thesis (MPhil)
Status: Unpublished
Schools: Biosciences
Subjects: Q Science > QM Human anatomy
Date of First Compliant Deposit: 30 March 2016
Last Modified: 05 Jun 2017 04:03
URI: http://orca-mwe.cf.ac.uk/id/eprint/48747

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