Journal List > J Korean Soc Surg Hand > v.21(2) > 1106553

J Korean Soc Surg Hand. 2016 Jun;21(2):84-88. Korean.
Published online June 24, 2016.  https://doi.org/10.12790/jkssh.2016.21.2.84
Copyright © 2016. The Korean Society for Surgery of the Hand
Flexor Pollicis Longus Reconstruction in Patient with the Linburg-Comstock Syndrome
Sung Jong Woo,1 and Sang Won Moon2
1Department of Orthopaedic Surgery, Prime Hospital, Busan, Korea.
2Department of Orthopaedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

Correspondence to: Sang Won Moon. Department of Orthopedic Surgery, Haeundae Paik Hospital, Inje University College of Medicine, 875 Haeun-daero, Haeundae-gu, Busan 48108, Korea. TEL: +82-51-797-0668, FAX: +82-51-797-0991, Email: oldeca5@naver.com
Received February 21, 2016; Revised June 09, 2016; Accepted June 12, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Linburg-Comstock phenomenon is defined simultaneous flexion of thumb and other fingers. The coupling of the flexor pollicis longus and flexor digitorum profundus tendons is the main pathognomonic feature of this lesion. Typically, pain is noted at the distal level of the forearm at the site of the abnormal connection. We describe a case of flexor pollicis longus tendon rupture who undergoes a carpal tunnel release, and report the Linburg-Comstock syndrome after the flexor tendon reconstruction.

Keywords: Flexor pollicis longus; Flexor digitorum profundus; Abnormal tendon connection; Linburg-Comstock syndrome

Figures


Fig. 1
(A) Severe tenosynovitis and adhesion were seen in radial side of the wrist. (B) A flexor pollicis longus tendon was ruptured and retracted.
Click for larger image


Fig. 2
Four months follow-up physical examination demonstrate active motion of right interphalangeal joint of thumb. (A) Active extension. (B) Active flexion.
Click for larger image


Fig. 3
Demonstration of the patient's simultaneous flexion of the interphalangeal joint of the thumb and the distal interphalangeal joint of the index finger (arrow) of the right hand.
Click for larger image

References
1. Linburg RM, Comstock BE. Anomalous tendon slips from the flexor pollicis longus to the flexor digitorum profundus. J Hand Surg Am 1979;4:79–83.
2. Miller G, Peck F, Brain A, Watson S. Musculotendinous anomalies in musician and nonmusician hands. Plast Reconstr Surg 2003;112:1815–1822.
3. Badhe S, Lynch J, Thorpe SK, Bainbridge LC. Operative treatment of Linburg-Comstock syndrome. J Bone Joint Surg Br 2010;92:1278–1281.
4. Lin B, Sreedharan S, Chin AY. Linburg-Comstock phenomenon following forearm laceration. Hand Surg 2012;17:221–224.
5. Boeckstyns ME, Sorensen AI. Does endoscopic carpal tunnel release have a higher rate of complications than open carpal tunnel release? An analysis of published series. J Hand Surg Br 1999;24:9–15.
6. Spar I. Flexor tendon ruptures in the rheumatoid hand: bilateral flexor pollicis longus rupture. Clin Orthop Relat Res 1977;(127):186–188.
7. Christodoulou L, Yang XB, Chamberlain ST. Rupture of flexor pollicis longus after carpal tunnel decompression. Injury 2000;31:744–745.
8. Hamitouche K, Roux JL, Baeten Y, Allieu Y. Linburg-Comstock syndrome: epidemiologic and anatomic study, clinical applications. Chir Main 2000;19:109–115.
9. Ortak T, Uraloglu M, Orbay H, Koc MN, Sensoz O. Linburg-Comstock anomaly: seems to be harmless but may be fatal. Plast Reconstr Surg 2007;119:1976–1977.
10. Barabás AG. Flexor pollicis longus tendon repair in patients with Linburg-Comstock anomaly. J Hand Surg Eur Vol 2013;38:203–204.
11. Kalappa S, Shankar R, Kadadi BK, Rajappa GC. Linburg-Comstock anomaly of the flexor tendons of hand. ANZ J Surg. 2014 Oct 07;10.1111/ans.12881