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Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_I | Pages 96 - 96
1 Mar 2009
Prause E Power D Khalid M Tan S
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Introduction: In 1979 Linburg and Comstock described anomalous tendon slips between flexor pollicus longus and the flexor digitorum profundus in 31% of individuals (Linburg, Comstock; J Hand surg 1997, Jan). The purpose of this study is to find out the incidence of Linburg-Comstock Syndrome in the British population.

Methods: A clinical examination of the hands of healthy volunteers, including office workers and medical professionals was carried out. It was determined if flexion of the thumb causes concomitant flexion of index or/and middle finger. Additionally, pain on passive extension of the fingers was also documented.

Summary of Results: 70 volunteers were included, the test for Linburg-Comstock syndrome was positive in 55% of people who had concomitant flexion of the fingers with the thumb and pain in the wrist with passive extension. In 70% of people just concomitant finger flexion was seen. In 10 cadaveric dissections no connecting tendon slips were found but one fibrinous connection between FPL and FDP was noted.

Conclusion: Our study shows that the incidence of Linburg –Comstock Syndrome is much higher than previously thought based on the clinical examination. However cadaveric dissections did not confirm a distinct structural connection except in one case where there was a fibrinous connection. It is likely that at least in some cases it is a acquired anomaly in response to repeated use/overuse of thumb and index fingers.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 536 - 536
1 Aug 2008
Killampalli VV Shears E Prause E O’Hara J
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Introduction Growth of femoral neck can be stunted due to early fusion of capital femoral epiphysis and can occur in DDH, LCPD and Septic Arthritis of Hip, while the greater trochanter (GT) continues to grow normally. This results in a high riding greater trochanter with altered abductor function and shortening of the involved limb. Management of patients with such deformities in adolescence is challenging, more so in planning to conserve the hip joint.

Methods and Results We wish to present our experience in the management of such deformed proximal femur with double femoral osteotomy in 15 patients (6 male, 9 female), mean age 22 (11–36) years with an average follow-up of five years. Average distalisation of GT was 2.2 cms and limb-length gained was 2.8 cms. Fracture of GT with displacement was the only complication encountered that required further surgery.

Discussion Primarily the procedure was performed to distalise the greater trochanter thereby improving abduction function, increasing the offset at the hip joint, and creating a more anatomical neck; so facilitating any subsequent joint-sacrificing procedure. Although the secondary benefit of the procedure was to gain limb length, this was what the patients appreciated was the greatest benefit. The technique demands detailed preoperative planning, detailed execution of the plan but produces consistently good results.