Lutsky Kevin, Matzon Jonas, Walinchus Lesley, Ross David A, Beredjiklian Pedro
The Rothman Institute, Philadelphia, PA.
The Rothman Institute, Philadelphia, PA.
J Hand Surg Am. 2014 Jun;39(6):1088-93. doi: 10.1016/j.jhsa.2014.02.033. Epub 2014 Apr 29.
To assess the normal degree of laxity of the collateral ligaments (CLs) of the finger metacarpophalangeal (MCP) joints and to compare side-to-side differences in CL laxity.
One hundred subjects had measurements of the degree of laxity in the radial (RCL) and ulnar (UCL) collateral ligaments of the MCP joints of each digit on both hands with the joints at neutral and at 30° and 90° of flexion using a custom-made measuring device. Statistical analysis was performed to assess both the difference in laxity for each ligament at each position of flexion and between sides for analogous ligaments (eg, the right index RCL at neutral compared to the left index RCL at neutral).
There was a significant decrease in laxity for all ligaments between neutral (mean, 24° laxity) and 90° of flexion (mean, 15° laxity). There was a side-to-side difference between the RCL of all digits in extension (mean, 3°) and the index RCL in flexion (2°). These differences were statistically significant but clinically minimal. There were no side-to-side differences between any of the other ligaments at any position.
Finger MCP joint CL stability increases with increasing flexion of the joint. There is little to no difference between analogous ligaments on either hand of the subject when tested in the same position of MCP joint flexion. Knowledge of the average degree of MCP joint CL laxity can be helpful in assessing a potentially injured joint. A patient's contralateral, uninjured side can be used to determine that individual's normal laxity and a substantial increase from this on an injured digit can indicate CL rupture.
TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
评估手指掌指（MCP）关节侧副韧带（CL）的正常松弛程度，并比较CL松弛度的左右差异。
100名受试者使用定制测量装置，测量双手各手指MCP关节的桡侧（RCL）和尺侧（UCL）副韧带在关节处于中立位、屈曲30°和90°时的松弛度。进行统计分析，以评估每个韧带在每个屈曲位置的松弛度差异，以及类似韧带（例如，中立位时右手示指RCL与左手示指RCL）的左右差异。
所有韧带在中立位（平均松弛度24°）和90°屈曲位（平均松弛度15°）之间的松弛度均显著降低。所有手指伸展时的RCL（平均3°）和示指屈曲时的RCL（2°）存在左右差异。这些差异具有统计学意义，但临床意义极小。在任何位置，其他韧带之间均无左右差异。
手指MCP关节CL稳定性随关节屈曲增加而增强。在MCP关节相同屈曲位置进行测试时，受试者双手类似韧带之间几乎没有差异。了解MCP关节CL的平均松弛度有助于评估潜在受伤的关节。患者对侧未受伤的一侧可用于确定个体的正常松弛度，受伤手指的松弛度较此有大幅增加可能表明CL断裂。
研究类型/证据水平：诊断性研究II级。
