PMID: 3760491Sep 1, 1986Paper

Lateral stability of the proximal interphalangeal joint

The Journal of Hand Surgery
T R KiefhaberE S Grood

Abstract

Current diagnostic criteria and therapeutic guidelines for injuries to the collateral ligaments of the proximal interphalangeal (PIP) joint are imprecise and vague. Laxity determinations, failure analysis, radiographic stress testing, and microscopic dissections were performed on 112 PIP joints. The lateral collateral ligament (LCL) is the primary restraint to varus and valgus angulation of the PIP joint. Its palmar fibers are tight in joint extension and provide the first line of resistance to lateral angulation. Failure of the LCL almost always occurs proximally in a sequential fashion that begins with the palmar fibers and progresses to the more dorsal bundles. Proximal LCL disruption is followed by separation of the accessory collateral-LCL junction and finally by failure of the distal palmar plate. Midsubstance tears of the LCL are rare. If the lateral stress test shows more than 20 degrees of varus or valgus angulation, the LCL can be presumed to be completely disrupted. Angulation of less than 20 degrees is associated with a 53% chance of partial LCL failure and a 47% chance of complete disruption, but the proper position of the LCL will be maintained by the overlying connective tissues. A clinical investigation will be ...Continue Reading

References

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Citations

Dec 18, 2002·Archives of Biochemistry and Biophysics·Victor Gavrilovich ZgodaMaria Almira Correia
Apr 6, 1999·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·H KatoH Kotaki
Dec 4, 2003·The Journal of Hand Surgery·Dean WernerSorin Seigler
May 21, 2003·Journal of Hand Therapy : Official Journal of the American Society of Hand Therapists·Shrikant J Chinchalkar, Bing Siang Gan
Mar 8, 2006·Techniques in Hand & Upper Extremity Surgery·M SauerbierR L Linscheid
Oct 21, 2000·The Journal of Hand Surgery·R L Linscheid
Dec 8, 2010·The Journal of Hand Surgery·Robert A KaufmannRobert J Goitz
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Jul 30, 2005·Arthritis and Rheumatism·Ai Lyn TanDennis McGonagle
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May 2, 2007·The Journal of Orthopaedic and Sports Physical Therapy·Peter V LoubertAaron M Mazza
Jan 13, 2005·The Journal of Orthopaedic and Sports Physical Therapy·Maureen A Hardy
Aug 5, 2016·JBJS Reviews·Randy Bindra, Julie Colantoni Woodside
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Jun 10, 1998·The Journal of Hand Surgery·T R Kiefhaber, P J Stern
Jul 1, 1993·The Journal of Hand Surgery·A P Weiss, H Hastings
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Jun 2, 2009·The Journal of Bone and Joint Surgery. British Volume·C Y Ng, C W Oliver
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