IRREDUCIBLE VOLAR SUBLUXATION OF THE PROXIMAL INTERPHALANGEAL JOINT DUE TO RADIAL COLLATERAL LIGAMENT INTERPOSITION: CASE REPORT AND REVIEW OF LITERATURE

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 153-157 ◽  
Author(s):  
Jason Pui Yin Cheung ◽  
Wing Lim Tse ◽  
Pak Cheong Ho
Keyword(s):  
Joint Stiffness ◽  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Careful Examination ◽  
Preoperative Imaging ◽  
Loss Of Function ◽  
Flexion Deformity ◽  
Collateral Ligament ◽  
Radial Collateral Ligament ◽  
Primary Assessment

Irreducible volar subluxation should be considered when assessing a patient with flexion deformity of the proximal interphalangeal finger joint (PIPJ). Primary assessment requires careful examination of the collateral ligaments and extensor tendon. Preoperative imaging such as ultrasound and MRI can help identify the interposed structures and plan the subsequent operation. Although rare, irreducible volar subluxation due to radial collateral ligament interposition is an important entity to be aware of. Prompt and appropriate management can prevent joint stiffness and loss of function.

Radial Collateral Ligament Injury of the Little Finger Proximal Interphalangeal Joint in Young Pianists

2014 ◽  
Vol 39 (8) ◽  
pp. 1535-1539 ◽  
Author(s):  
Hyun Sik Gong ◽  
Hoyune Esther Cho ◽  
Seung Hwan Rhee ◽  
Jihyeong Kim ◽  
Young Ho Lee ◽  
...  
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Radial Collateral Ligament ◽  
Little Finger

Management of feline carpal injuries: What are the options and when is arthrodesis indicated?

2019 ◽  
Vol 21 (9) ◽  
pp. 809-823 ◽  
Author(s):  
Rachel M Basa ◽  
Kenneth A Johnson
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Evidence Base ◽  
Careful Examination ◽  
Current Evidence ◽  
Collateral Ligament ◽  
Retrospective Case ◽  
Radial Collateral Ligament ◽  
Current Evidence Base ◽  
Direct Extrapolation

Practical relevance: Feline carpal injuries are usually caused by falls from a height that result in hyperextension injury or antebrachiocarpal luxation or subluxation. Isolated ligamentous damage or fracture of the carpus is unusual; it is more common to have a combination of both in the cat. These injuries can be debilitating since cats climb and jump from great heights, and have a greater range of antebrachial pronation and supination than dogs. Anatomy: There are differences in the anatomy of the feline and canine carpus. In particular, cats only have a single short radial collateral ligament, also known as the medial collateral ligament. This means that, in the cat, antebrachiocarpal subluxation is possible with rupture of the dorsal joint capsule and short radial collateral ligament alone. Clinical challenges: Many feline carpal injuries can be treated without performing pancarpal arthrodesis. However, determining which ligaments and joint levels are affected requires careful examination and often stress radiography. When pancarpal arthrodesis is performed in the cat, it has been reported to reduce the height of jumping and to increase reluctance to climb. This is speculated to be due to reduced pronation and supination movement of the carpus. Evidence base: The current evidence base for management of feline carpal injuries is grade III or IV, with most of the studies being retrospective case series involving cadaveric dissection or direct extrapolation from published information about the dog. There are few guidelines regarding the optimal treatment options for carpal injuries in the cat.

Swan neck deformity due to chronic radial collateral ligament injury of the little finger proximal interphalangeal joint

2017 ◽  
Vol 43 (5) ◽  
pp. 513-517
Author(s):  
Yoshitaka Hamada ◽  
Hiroaki Takai ◽  
Ryousuke Satoh ◽  
Naohito Hibino ◽  
Yukiko Ueda ◽  
...  
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Ligament Injury ◽  
Collateral Ligament ◽  
Level Of Evidence ◽  
Ulnar Deviation ◽  
Radial Collateral Ligament ◽  
Palmar Plate ◽  
Pip Joint ◽  
Swan Neck Deformity ◽  
Little Finger

We present seven cases of a relatively rare swan neck deformity resulting from chronic radial collateral ligament (RCL) injury of the proximal interphalangeal (PIP) joint in the little finger. All patients were middle-aged women (mean 51 years old, range 42–55), and the duration between the initial injury and surgery was 20 years (range 5–40). The chief complaint was painful snapping of the PIP joint. All patients had hyperextension and ulnar deviation of the PIP joint with mobile swan neck deformities that had not improved with conservative treatment. Radiographs revealed osteoarthritis and ulnar deviation of the PIP joints in all cases. We describe a method for reconstruction of both the palmar plate and the RCL of the affected PIP joint using a distally-based ulnar slip of flexor superficialis tendon. The prevention of PIP joint hyperextension was critical for successful resolution of symptoms; the aim of RCL augmentation was to prevent the recurrence of the deformity. Level of evidence: IV

Angular correction related to excision of specific cords in fasciectomy for Dupuytren’s disease

2013 ◽  
Vol 39 (5) ◽  
pp. 472-476 ◽  
Author(s):  
R. W. Trickett ◽  
R. Savage ◽  
A. J. Logan
Keyword(s):  
Joint Angle ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Dupuytren’S Disease ◽  
Flexion Deformity ◽  
Collateral Ligament ◽  
Dupuytren's Disease ◽  
Lateral Cord ◽  
Angular Correction

Named cords were excised sequentially at fasciectomy for Dupuytren’s disease and the resultant correction in the joint angle was measured intra-operatively in 99 fingers. Eighty-two metacarpophalangeal and 59 proximal interphalangeal joints were affected. At the metacarpophalangeal joint, excision of the central cord resulted in 82% correction in 69 joints, and spiral/lateral cord excision resulted in an additional 12% correction in 10 joints. At the proximal interphalangeal joint, excision of the central cord resulted in 44% correction in 36 joints, spiral/lateral cord excision resulted in an additional 19% correction in 16 joints, and retrovascular cord excision resulted in a further 23% correction in 27 joints. Subsequent division of the accessory collateral ligament resulted in a further 14% correction in 14 joints. Larger pre-operative angles of the proximal interphalangeal joint were associated with a retrovascular cord, and larger combined angles were associated with an increasing number of pathological structures involved. The data explain the complexity of surgery at the proximal interphalangeal joint, where four structures are implicated in causing flexion deformity.

scholarly journals Results of tension band wiring in intra-articular collateral ligament avulsion fractures of the phalanx

2018 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Rajeev Raj Manandhar ◽  
Shishir Lakhey ◽  
Umash Karki
Keyword(s):  
Functional Outcome ◽  
Soft Tissues ◽  
Proximal Phalanx ◽  
Ring Finger ◽  
Ulnar Collateral Ligament ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Collateral Ligament ◽  
Avulsion Fractures ◽  
Radial Collateral Ligament

Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult.Objective: The purpose of this study was to assess the functional outcome of tension band wiring in intra-articular avulsion fractures of the base of the proximal phalanx.Methodology: A prospective study was performed on ten patients with intra-articular collateral ligament avulsion fractures of the proximal phalanx (Jupiter’s classification Type III). A tension band construct was performed using a dorsal approach. The functional outcome was assessed at six months with the quick Disability of Arm, Shoulder and Hand score.Results: The mean age of the patients was 25.8 years (Mean ± SD: 25.80). Six avulsion fractures were of the ulnar collateral ligament of the proximal phalanx of the index finger, one involved the radial collateral ligament of the ring finger and three, the radial collateral ligament of the little finger suggesting an abduction injury. All fractures had united at three months. Eight patients were graded as excellent and two as good. All patients were satisfied with the surgery and the functional outcome of the injured digit. There were no perioperative complications.Conclusion: The functional outcome of tension band wiring in intra-articular collateral ligament avulsion fractures of the base of the proximal phalanx was good to excellent.

ROTATORY SUBLUXATION OF THE METACARPOPHALANGEAL INDEX FINGER JOINT: A CASE REPORT

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 103-105 ◽  
Author(s):  
Ken Teo ◽  
Anthony Berger
Keyword(s):  
Case Report ◽  
Index Finger ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Clinical Suspicion ◽  
Collateral Ligament ◽  
Open Injury ◽  
Complete Tear ◽  
Rotatory Subluxation ◽  
High Level

We report a case of rotatory subluxation of the metacarpophalangeal joint (MCPJ) of the finger. A 40-year-old man sustained an open injury to his index finger following an explosive injury. Radiographs showed rotatory subluxation of the index finger MCPJ. The index finger extensor digitorium was found interposed in the MCPJ, with a complete tear of the radial collateral ligament. Treatment was by open reduction and repair of the collateral ligament and the extensor tendon. A high level of clinical suspicion is needed to diagnose this entity.

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