Biomechanical Analysis of Flexor Digitorum Profundus and Superficialis in Grip-Strength Reduction

Grip strength is generated through extrinsic flexor tendon and intrinsic muscle actuation. In the study reported here, we analyzed the grip-generating properties of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons during grip-strength generation. In vivo gripping was reproduced in 11 cadaveric forearms through pneumatic tensioning of flexor tendons. A Jamar dynamometer (TEC, Clifton, NJ) was positioned in the hand at varying degrees of angulation measured between the Jamar compression axis and the second metacarpal. Maximum gripping strength during isolated FDP and FDS tensioning generated maximum compressive forces at different angles (P<.0001). The isolated FDP showed continued increased grip strength with larger angles and was most effective when the dynamometer handle was in contact with the distal phalanx. The isolated FDS was most effective at smaller angles when the handle made contact with the middle phalanx. The isolated FDS shows an initial increase in grip strength as the contact point moves toward the middle phalanx (P<.01) and then a tendency for grip strength to decline as the contact point moves over the distal phalanx (P<.01). The FDP and FDS tendons demonstrate unique abilities to generate compression on a dynamometer. This knowledge is important to consider when evaluating grip strength in patients who have injured the extrinsic finger flexors.