Journé A, Dana C, Kilinc A S, Nourissat G, Doursounian L
Service de chirurgie orthopédique, université Pierre-et-Marie-Curie Paris, hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
Chir Main. 2013 Jun;32(3):176-9. doi: 10.1016/j.main.2013.03.003. Epub 2013 Apr 9.
Volar rotatory dislocation of the proximal interphalangeal joint results from volar rotation of the condyle around an intact opposite collateral ligament. A cadaveric study was preformed to better understand the mechanisms of this injury. Thirty-two long fingers (II to V) were studied. After partial section of the triangular ligament, the radial collateral ligament was cut (partly or completely, at proximal or distal insertion) and volar rotatory dislocation was induced. We studied the incidence of a fixed dislocation, the distal extension of the triangular ligament lesion, and the Stener lesion of the radial collateral ligament. A buttonhole lesion was produced by a dislocated lateral band in all cases with complete section of the collateral ligament. When the lesion of the triangular ligament extended distally, dislocation became irreducible. A Stener effect (interposition of the lateral band between the condyle and the collateral ligament) was observed after reduction in 21% of cases with proximal lesions of the radial collateral ligament.
近端指间关节掌侧旋转脱位是由髁围绕完整的对侧副韧带进行掌侧旋转所致。进行了一项尸体研究以更好地理解这种损伤的机制。研究了32根长手指（示指至小指）。在部分切断三角韧带后，切断桡侧副韧带（部分或完全切断，在近端或远端附着点处）并诱发掌侧旋转脱位。我们研究了固定性脱位的发生率、三角韧带损伤的远端延伸情况以及桡侧副韧带的斯滕纳（Stener）损伤。在所有侧副韧带完全切断的病例中，脱位的外侧束均造成了纽扣孔样损伤。当三角韧带的损伤向远端延伸时，脱位变得无法复位。在桡侧副韧带近端损伤的病例中，21%在复位后观察到了斯滕纳效应（外侧束在髁与副韧带之间的嵌入）。
