From the Guidelines
The tendons involved in the movement of the Metacarpophalangeal (MCP) joint are primarily the flexor digitorum superficialis and profundus tendons for flexion, and the extensor digitorum tendons for extension. The movement at the MCP joint involves a complex interplay of these tendons, with the flexor tendons allowing for flexion and the extensor tendons facilitating extension.
Key Tendons Involved
- Flexor digitorum superficialis
- Flexor digitorum profundus
- Extensor digitorum Injuries to these tendons can significantly impact the function and mobility of the hand, emphasizing the need for prompt and appropriate treatment. According to 1, MRI is ideal for evaluating tendon injuries and helping with surgical planning, which is crucial for optimal outcomes in the treatment of MCP tendon injuries.
Treatment Approaches
- Conservative management for partial tendon tears, including immobilization and gradual rehabilitation exercises
- Surgical repair for complete tendon ruptures, followed by protected motion protocols and rehabilitation Early intervention and proper treatment are essential to prevent long-term complications such as stiffness, contractures, and permanent functional limitations, as highlighted by the importance of timely diagnosis and treatment in 1.
From the Research
Tendons Involved in Metacarpophalangeal Joint Movement
- The extensor digitorum communis (EDC) tendon is primarily responsible for extending the metacarpophalangeal (MCP) joint 2.
- The sagittal bands act as a stabilizer, but not as a primary extensor of the MCP joint 2.
- The extensor tendon continuation to the extensor hood and middle phalanx is the major extension motor 2.
Injuries to Metacarpophalangeal Joint Tendons
- Extensor tendon subluxation can result from a disruption to the extensor retinacular system and/or the sagittal band at the MCP joint 3.
- Injuries to the EDC tendon or sagittal bands can lead to reduction of the excursion of the adjacent extensor tendons, resulting in an abnormal pathomechanical kinematic chain imbalance 4.
- Treatment of these injuries may involve surgical techniques, such as reconstructive stabilization or substitution techniques, to centralize the extensor tendon and restore normal function 3, 5.
Treatment of Metacarpophalangeal Joint Tendon Injuries
- Surgical treatment is necessary when conservative treatment is insufficient to correct the subluxation or injury 3.
- Various surgical techniques exist, including the use of a junctura tendinum to lengthen an EDC tendon graft 3 or the creation of a tether between the second and third EDC tendons 5.
- Early identification and treatment of these injuries is critical to address the extensor quadriga entity and prevent long-term complications 4.