Change in the collateral and accessory collateral ligament lengths of the proximal interphalangeal joint using cadaveric model three-dimensional laser scanning

2015 ◽  
Vol 41 (4) ◽  
pp. 380-385
Author(s):  
S. S. Sandhu ◽  
S. Dreckmann ◽  
P. A. Binhammer
Keyword(s):  
Laser Scanning ◽  
Index Finger ◽  
Three Dimensional ◽  
Middle Finger ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Ligament Length ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Level Of Evidence

The purpose of this study was to assess the lengths of the index and middle finger proximal interphalangeal joint ligaments and determine the relative changes in the collateral and accessory collateral ligament lengths at 0°, 45° and 90° flexion. We generated three-dimensional scans of 16 finger (eight index and eight middle) proximal interphalangeal joints to assess relative changes in ligament length. Significant changes were found between 45°–90° and 0°–90° for the ulnar collateral ligament of the index finger and both collateral ligaments of the middle finger between 45°–90° and 0°–90°. No significant changes in length were found for the radial collateral ligament of the index finger or the accessory collateral ligaments of the index and middle fingers. Overall, it was found that the collateral ligament length changed significantly, but there was no significant change in the accessory collateral ligaments. Type of study/level of evidence: Therapeutic IV

Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint

2013 ◽  
Vol 26 (06) ◽  
pp. 489-492 ◽  
Author(s):  
S. Berchtold ◽  
J. M. Kuemmerle
Keyword(s):  
Articular Cartilage ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Joint Disease ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Contralateral Limb ◽  
Conventional Procedure ◽  
Articular Cartilage Surface ◽  
The Difference

SummaryThis study compared the areas of cartilage accessible for curettage in arthrodesis of the equine proximal interphalangeal joint using the conventional and collateral ligament sparing approaches. For this purpose, forelimbs and hindlimbs of six equine cadavers without radiographic evidence of proximal interphalangeal joint disease were used. One limb of each pair of limbs was randomly assigned to a dissection using a standard approach to the proximal interphalangeal joint including transection of the collateral ligaments, while each contralateral limb was exposed using the same approach but leaving the collateral ligaments intact. Hohmann retractors and Spratt curettes were then used to remove as much articular cartilage as possible. Finally, proximal interphalangeal joints were photographed and image analysis was performed.Using the collateral ligament sparing procedure, the mean percentage of articular cartilage surface removed (41.2%) was significantly less than using the conventional procedure (79.6%) (p <0.01). The difference between forelimbs and hindlimbs was not significant.

The Treatment of Chronic Flexion Contractures of the Proximal Interphalangeal Joint

1995 ◽  
Vol 20 (3) ◽  
pp. 385-389 ◽  
Author(s):  
G. ABBIATI ◽  
G. DELARIA ◽  
E. SAPORITI ◽  
M. PETROLATI ◽  
C. TREMOLADA
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Extension Deficit ◽  
Flexion Contractures ◽  
Complete Extension ◽  
Pip Joint ◽  
Surgical Release

A method of treatment of chronic flexion contractures of the PIP joint is presented, with the results obtained in 19 patients treated between 1989 and 1992 after a follow-up of from 6 to 53 months. The flexion contractures, with an extension deficit which ranged between 70 and 90°, had been present for a period of between 2 months and 24 years. Our treatment program involves the surgical release of the unreducible PIP joint followed by the use of static and/or dynamic splints. Surgery is performed using a midlateral approach; the accessory collateral ligament and the flexor sheath are incised and, after the volar plate and check-rein ligaments have been excised, forced hyperextension is applied. The main collateral ligaments are carefully spared and freed from the condyle if there are any remaining adhesions. In our 19 patients, complete extension of the finger was achieved in 11 cases (57.9%); in the remaining 8 cases (42.1%) the residual extension deficit ranges from 10 to 15°. In our experience this combined surgical and rehabilitative approach had led to consistently good results with minimal complications.

Three-dimensional analysis of the palmar plate and collateral ligaments at the proximal interphalangeal joint

2013 ◽  
Vol 39 (4) ◽  
pp. 391-397 ◽  
Author(s):  
S. W. J. Lee ◽  
Z. Y. Ng ◽  
Q. A. Fogg
Keyword(s):  
Virtual Environment ◽  
Dimensional Analysis ◽  
Three Dimensional ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Middle Phalanx ◽  
Palmar Plate ◽  
3D Virtual Environment

The purpose of this study was to analyze the palmar plate complex at the proximal interphalangeal joint using a three-dimensional (3D) technique, which makes it easier to understand the dimensions of structures and their relationship to the adjacent components. This method allows individual elements to be removed virtually, facilitating clearer observation of each component. Sixteen cadaveric specimens were dissected and reconstructed in a 3D virtual environment. The palmar plate is made up of a distal, fibrous portion and a proximal, membranous portion, which anchors distally on the base of the middle phalanx and is continuous with the bilateral check-rein ligaments proximally. The accessory collateral ligaments and the A3 pulley suspend the palmar plate laterally.

Irreducible Volar Rotatory Subluxation of the Proximal Interphalangeal Joint of the Finger

2018 ◽  
Vol 23 (01) ◽  
pp. 111-115
Author(s):  
Masahiko Tohyama ◽  
Sadahiko Konishi
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Lateral View ◽  
Interphalangeal Joint ◽  
Collateral Ligaments ◽  
Middle Phalanx ◽  
Collateral Ligament ◽  
Pip Joint ◽  
Central Slip ◽  
Rotatory Subluxation ◽  
Careful Physical Examination

We describe 4 cases of irreducible volar rotatory subluxation of the proximal interphalangeal (PIP) joint of the finger that required open reduction. All of the patients had radiographically proven (in lateral-view radiographs) volar rotatory subluxation of the PIP joint, without fracture. The causes of irreducibility were interposition of the lateral band about the condyle of the middle phalanx in 2 cases, interposition of the collateral ligament in 1 case, and scarring of the injured central slip in 1 case. Rupture of the collateral ligament of one side was found in all cases. Acceptable results were provided with all cases after restoration of the collateral ligaments and the damaged parts. Accurate early diagnosis by careful physical examination and obtaining true lateral radiographs of the PIP joint is important.

Rotatory subluxation of the proximal interphalangeal joint: an easily missed diagnosis

2021 ◽  
Vol 14 (1) ◽  
pp. e237402
Author(s):  
Angelos Assiotis ◽  
Christopher Jenkins ◽  
Rouin Amirfeyz
Keyword(s):  
Index Finger ◽  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Collateral Ligament ◽  
Acute Setting ◽  
Central Slip ◽  
Rotatory Subluxation ◽  
Missed Diagnosis ◽  
Initial Delay

We present a case of volar rotatory subluxation of index finger proximal interphalangeal joint (PIPJ) following a skiing accident. The injury was initially perceived to be a central slip rupture and treatment was directed as such. After the initial delay in the diagnosis, the patient underwent surgery during which his radial collateral ligament was found to be avulsed from the proximal origin, the radial lateral band palmarly subluxed and was interposed in the joint space. This structure was also adhered to the uninjured volar plate.PIPJ volar rotatory subluxation could be readily missed in the acute setting. Without surgery, the functional outcome could be mediocre and to the patient’s detriment.

Digital artery deformation on movement of the proximal interphalangeal joint

2018 ◽  
Vol 44 (2) ◽  
pp. 187-195
Author(s):  
Susumu Saito ◽  
Ryoma Bise ◽  
Aya Yoshikawa ◽  
Hiroyuki Sekiguchi ◽  
Itaru Tsuge ◽  
...  
Keyword(s):  
Index Finger ◽  
Three Dimensional ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Three Dimensions ◽  
Morphological Data ◽  
Photoacoustic Tomography ◽  
Digital Artery ◽  
Specific Mechanism

This study aimed to characterize in vivo human digital arteries in three-dimensions using photoacoustic tomography in order to understand the specific mechanism underlying arterial deformation associated with movement of the proximal interphalangeal joint. Three-dimensional morphological data were obtained on the radialis indicis artery (radial artery of the index finger) at different angles of the joint. The association between increased curvature of the deformation and the anatomical region was assessed. Characteristic morphological deformations in areas of major deformation were determined. The deformation of the artery was characterized by three consecutive curves in juxta-articular regions, which were particularly noticeable when the joint was flexed at an angle of ≥ 60°. The change in the curvature of the deformation during 30°–90° of flexion was lower in middle-aged individuals than in young individuals. Better understanding of the mechanism underlying deformation of the digital arteries may contribute to advancements in flap procedures and rehabilitation strategies after digital artery repair.

scholarly journals Prospective, Multicenter, Clinical and Radiographic Evaluation of a Biointegrative, Fiber-Reinforced Implant for Proximal Interphalangeal Joint Arthrodesis

2020 ◽  
Vol 5 (4) ◽  
pp. 247301142096631
Author(s):  
Luke D. Cicchinelli ◽  
Jurij Štalc ◽  
Martinus Richter ◽  
Stuart Miller
Keyword(s):  
Adverse Events ◽  
Prospective Trial ◽  
Case Series ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Radiographic Evaluation ◽  
Fiber Reinforced ◽  
Level Of Evidence ◽  
Surgery Patient ◽  
Patient Reported

Background: A novel biointegrative implant was developed for proximal interphalangeal joint (PIPJ) arthrodesis to treat hammertoe deformity. Composed of continuous reinforcing mineral fibers bound by bioabsorbable polymer matrix, the implant demonstrated quiescent, gradual degradation with complete elimination at 104 weeks in animal models. This prospective trial assessed the implant’s safety, clinical performance, and fusion rate of PIPJ arthrodesis for hammertoe correction. Methods: Twenty-five patients (mean age 63.9±7.5 years) who required PIPJ arthrodesis were enrolled at 3 centers. Outcomes included radiographic joint fusion, adverse events, pain visual analog scale (VAS) score, Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) score, and patient satisfaction. Patients were evaluated 2, 4, 6, 12, and 26 weeks postoperatively. Results: Twenty-two patients (88%) achieved radiographic fusion at 26 weeks. All joints (100%) were considered clinically stable, with no complications or serious adverse events. Pain VAS improved from 5.3±2.5 preoperatively to 0.5±1.4 at 26 weeks postoperatively. FAAM-ADL total scores and level of functioning improved by mean 19.5±19.0 points and 24.4±15.7 percentage points, respectively, from preoperation to 26 weeks postoperation. Improvements in pain VAS and FAAM scores surpassed established minimal clinically important differences. All patients were very satisfied (84%) or satisfied (16%) with the surgery. Patient-reported postoperative results greatly exceeded (72%), exceeded (20%), or matched (8%) expectations. Conclusion: This prospective, multicenter, first-in-human clinical trial of a novel biointegrative fiber-reinforced implant in PIPJ arthrodesis of hammertoe deformity demonstrated a favorable rate of radiographic fusion at 12 and 26 weeks, with no complications and good patient-reported clinical outcomes. Level of Evidence: Level IV, prospective case series.

Extensor Indicis Opposition Transfer in The Ulnar and Median Palsied Thumb in Leprosy

1996 ◽  
Vol 21 (5) ◽  
pp. 617-621 ◽  
Author(s):  
R. MEHTA ◽  
G. N. MALAVIYA ◽  
S. HUSAIN
Keyword(s):  
Index Finger ◽  
Donor Site ◽  
Metacarpophalangeal Joint ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Pollicis Longus ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Leprosy Patients ◽  
Significant Deficit

Twenty seven opponensplasties for ulnar and median paralysis in 25 leprosy patients were performed using extensor indicis proprius. An additional transfer of the radial half of flexor pollicis longus to extensor pollicis longus was done to stabilize the metacarpophalangeal joint of the thumb. The biomechanical aspects of extensor indicis proprius tendon transfer were studied and results evaluated using various anatomical and functional parameters. Extensor indicis proprius provides adequate strength to position the thumb. However, sometimes it does not reach its new insertion. There is no significant deficit at the donor site but in a few cases the index finger may lose its capability for independent extension and sometimes a proximal interphalangeal joint contracture may develop.

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