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http://hdl.handle.net/1942/40244Full metadata record
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | van Strien, Gwendolyn | - |
| dc.contributor.author | VAN ZWIETEN, Koos Jaap | - |
| dc.date.accessioned | 2023-06-01T10:42:19Z | - |
| dc.date.available | 2023-06-01T10:42:19Z | - |
| dc.date.issued | 2023 | - |
| dc.date.submitted | 2023-05-30T13:04:07Z | - |
| dc.identifier.citation | Journal of Hand Therapy, 36 (2), p. 280-293 | - |
| dc.identifier.issn | 0894-1130 | - |
| dc.identifier.uri | http://hdl.handle.net/1942/40244 | - |
| dc.description.abstract | Background: For hand therapists and hand surgeons acute and chronic injuries of the extensor mechanism (EM) in zones III-IV are challenging to treat with satisfying results. Introduction: Early active motion combined with relative motion flexion (RMF) orthoses to manage EM zone III injuries and boutonnière deformity has renewed interest in the complex anatomy and biomechanics of the EM. Purpose: To provide an in-depth discussion of EM zones III-IV anatomy with emphasis on inter-tendinous structures, often omitted in simplified, model-wise illustrations which focus mostly on the tendinous structures. Method: In collaboration the authors combined on the one hand extensive clinical experience and knowl edge of the EM literature and on the other hand decades of anatomical, biomechanical and kinesiology research of the EM with special interest for the spiral fibers, through gross anatomy and microdissection anatomy laboratory work, MRI and ultrasonography studies. Results: The inter-tendinous tissues (i.e., spiral fibers) in zone III are of imminent importance for proper functioning of the EM and to prevent boutonnière deformity to develop after EM surgery or injury. Discussion: Inter-tendinous links between the tendinous structures of the EM are necessary for balanced finger motion. The spiral fibers are described in more detail because of their role in controlling volar migration of the conjoined lateral bands and because their disruption makes development of boutonnière deformity more likely. Understanding the anatomy and biomechanics of the EM may assist in progress toward ‘proof of concept’ for use of RMF orthoses and controlled early active motion after EM injury or surgery. Conclusion: Hand surgery and hand therapy practice interventions, including use of RMF orthoses for management of non-surgical and surgical EM injuries may benefit from an in-depth look at the EM zone III and IV anatomy and biomechanics. | - |
| dc.description.sponsorship | The authors thank Julianne W. Howell, for her invaluable help and support in writing this article. | - |
| dc.language.iso | en | - |
| dc.publisher | Elsevier Inc. | - |
| dc.rights | 2023 Elsevier Inc. All rights reserved | - |
| dc.subject.other | Anatomy | - |
| dc.subject.other | Boutonnière | - |
| dc.subject.other | Relative motion | - |
| dc.subject.other | Spiral fibers | - |
| dc.subject.other | Orthotic devices | - |
| dc.subject.other | Central slip injury | - |
| dc.title | An in-depth look at zone III and IV anatomy of the finger extensor mechanism and some clinical implications for use of the relative motion flexion orthosis | - |
| dc.type | Journal Contribution | - |
| dc.identifier.epage | 293 | - |
| dc.identifier.issue | 2 | - |
| dc.identifier.spage | 280 | - |
| dc.identifier.volume | 36 | - |
| local.format.pages | 13 | - |
| local.bibliographicCitation.jcat | A1 | - |
| local.publisher.place | 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA | - |
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J Hand Surg Am. 1994;19:991-997. 79. Johnson C, Swanson M, Manolopoulos K. Treatment of a zone III extensor tendon injury using a single relative motion with dorsal hood orthosis and a modified short arc motion protocol—A case report. J Hand Ther. 2021; 34(1), 135-141. 80. Hirth MJ, Howell J, O'Brien L. Relative motion orthoses in the management of various hand conditions: A scoping review. Hand Ther. 2016;29:405–432. 81. Merritt WH, Jarrell K. A Paradigm Shift in Managing Acute and Chronic Boutonnière Deformity: Anatomic Rationale and Early Clinical Results for the Relative Motion Concept Permitting Immediate Active Motion and Hand Use. Ann Plast Surg. 2020 Mar;84(3S Suppl 2):S141-S150. doi: 10.1097/SAP.0000000000002307. PMID: 32028337. 82. Colzani G, Tos P, Battiston B, Merolla G, Porcellini G, Artiaco S. Traumatic Extensor Tendon Injuries to the Hand: Clinical Anatomy, Biomechanics, and Surgical Procedure Review J Hand Microsurg. 2016 Apr; 8(1): 2–12. doi: 10.1055/s-0036-1572534 PMCID: PMC5016980 PMID: 27616821 83. Johnson Manopoulos 2023 JHT (is from the same journal as our article so cannot be filled in yet) | - |
| local.type.refereed | Refereed | - |
| local.type.specified | Article | - |
| dc.identifier.doi | 10.1016/j.jht.2023.01.002 | - |
| dc.identifier.pmid | 37085432 | - |
| dc.identifier.isi | 001071856900001 | - |
| dc.description.other | "This article provides an overview of extensor zones III-IV finger extensor mechanism (EM) anatomy and kinesiology, in particular details of zone III, which we believe have been under- or misreported. We have combined more recent imaging findings with sometimes century old morphological publications to unravel and weave together how we believe the EM in zone III functions both normally and pathologically after proximal interphalangeal joint (PIPJ) injury or surgery. We have applied this basic science to the use of the relative motion flexion (RMF) orthosis to restore normal balance of finger extension after a zone III injury, surgery or any loss of active PIPJ extension." | - |
| dc.identifier.eissn | 1545-004X | - |
| local.provider.type | - | |
| local.uhasselt.international | yes | - |
| item.fulltext | With Fulltext | - |
| item.accessRights | Open Access | - |
| item.fullcitation | van Strien, Gwendolyn & VAN ZWIETEN, Koos Jaap (2023) An in-depth look at zone III and IV anatomy of the finger extensor mechanism and some clinical implications for use of the relative motion flexion orthosis. In: Journal of Hand Therapy, 36 (2), p. 280-293. | - |
| item.contributor | van Strien, Gwendolyn | - |
| item.contributor | VAN ZWIETEN, Koos Jaap | - |
| crisitem.journal.issn | 0894-1130 | - |
| crisitem.journal.eissn | 1545-004X | - |
| Appears in Collections: | Research publications | |
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