Tendon Evaluation Tests
The specific tests required for tendon evaluation include:
Flexor digitorum superficialis (FDS)
Testing the flexor digitorum superficialis (FDS):
The patient should bend the finger whilst the others are held in full extension (thereby inactivating the deep flexors). The DIPJ should be flaccid. The exception is the index finger, which has a separate muscle belly so that extending the other digits does not isolate the FDS.
For FDS to the index finger test by checking the resisted PIPJ flexion while keeping the DIPJ extended.
Flexor digitorum profundus (FDP)
Testing the flexor digitorum profundus (FDP):
With the examiner holding the PIPJ in extension, the patient should be asked to flex the tip of the finger.
Extensor tendons
Testing the extensor tendons
The fingers should be straightened against resistance. The long extensors straighten at the MCPJ, and resistance should be applied to the dorsum of the proximal phalanx.
Extension at the PIPJ can be caused by the intrinsic muscles. Observe for loss of active extension at the DIPJ, i.e. a mallet deformity.
Flexor pollicis longus (FPL)
Testing the flexor pollicis longus (FPL)
Hold the thumb over the proximal phalanx and ask the patient to bend the tip.
Extensor pollicis longus (EPL)
Testing the extensor pollicis longus (EPL)
With the patients hand palm-down on a table, ask the patient to lift up his/her thumb, against resistance.