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Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 37 - 37
1 Mar 2006
Singh R Kakarala G Persaud I Roberts M Standring S Compson J
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Suture anchors have changed the practice of repair of tendons in modern Orthopaedics. The purpose of the study was to identify the ideal suture anchor length for anchoring flexor digitorum profundus tendon to the distal phalanx.

We dissected 395 distal phalanges from 80 embalmed hands. Phalanges from two little fingers and three thumbs were damaged, hence were excluded from the study. We measured the Anteroposterior and Lateral dimensions at three fixed points on the distal phalanges of all 395 fingers using a Vernier’s Callipers with 0.1mm accuracy.

The mean value of the Anteroposterior width of the distal phalanx at the insertion of the FDP was found to be 3.4mm for the little finger; 3.9mm for the ring finger; 4.3mm for the middle finger; 4.0mm for the index finger and 5.0mm for the thumb respectively. The commonly available anchors and drill bits were found to be too long when used for anchoring the flexor digitorum profundus tendon in certain distal phalanges. Our findings may be a reason for poor outcome of FDP repair to distal phalanx using suture anchors. New designs for tissue anchors for distal phalanges may be necessary.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 133 - 133
1 Mar 2006
Singh R Roberts M Persaud I Sinha J Standring S
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The purpose of the study was to define the anatomy of the distal biceps tendon and it’s attachment to the proximal radius (bicipital tuberosity). Distal ruptures of the biceps tendon are not uncommon. Surgical treatment needs an understanding of the precise anatomy of the distal biceps tendon and it’s insertion; of which there are no reports in the literature.

Eighty cadaver elbows were dissected. Six were damaged, hence they were excluded from the study. The skin over the cadaver elbows was removed. The distal biceps tendon was dissected and followed to it’s insertion on to the bicipital tuberosity. Measurements of tendon dimensions were taken at the elbow joint and at it’s insertion.

The whole distal biceps tendon twists in a predictable manner. The tendon fibres too change orientation. The tendon inserts on the posterior margin of the bicipital tuberosity in a thin C-shaped manner. All the biceps insertions had a significantly large bursa associated with it.

Both the biceps tendon and it’s intra-tendinous fibres twist. This has biomechanical implications. The dimensions of the biceps tendon at the elbow and at it’s insertion affect the biomechanics. The insertion into bone in a thin C shaped fashion has connotations on methods of repair.