Syndrome of Quadriga – Pathomechanics & Management

Presented by: Shrikant J. Chinchalkar, OTR, CHT

Saturday, October 23rd, 2021

10 AM – 11.30 AM (EST) 

1.5 hours continuing education credit

All content of this webinar series is accepted as Category A credit toward recertification by The Hand Therapy Certification Commission (HTCC)

Webinar Description:  

A classic feature of Flexor Digitorum Profundus (FDP) musculo-tendinous structure is that the tendons are interconnected, limiting them independently move the fingers. Verdan, in 1960 identified that reduced gliding amplitude of one of the FDP tendon will affect the flexion of the neighbouring fingers equally. He called this phenomenon as a “Quadriga” effect. Similar to the FDP, the Extensor Digitorum Communis (EDC) is a common muscle belly powering all the fingers. Therefore, the reduced gliding amplitude of one of the EDC tendons consequently affects the extension of adjacent fingers. Wilhelm first reported the “Extensor Quadriga” in 1988 and the presenter of this webinar contributed to the understanding of pathomechanics associated with this condition. If “Quadriga” of the flexor or extensor is unrecognized and untreated secondary pathomechanical changes will have unresolvable deformities. This presentation discusses the anatomy, and biomechanics of this phenomenon in details to help explain why certain conditions contribute to “Flexor and/or Extensor Quadriga”, which secondary deformities occur as a result and, how to treat these conditions successfully.

The presentation includes illustrations, animations, clinical and the cadaveric dissection videos to simplify understanding of the normal and disturbed digital mechanics. The use of the above-mentioned media is to contribute to the evidence of clinical management.

Objectives: 

Upon completion of the webinar the participants will have:

1. A thorough knowledge of FDP and EDC anatomy & function
2. An understanding of flexor and extensor quadriga biomechanics
3. An understanding of various injuries that produces the quadriga effect
4. An understanding of quadriga complications and management
5. An understanding of how to successfully diagnose and treat flexor & extensor quadriga