LINBURG-COMSTOCK SYNDROME REVISITED

Abstract

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.