Lazarus P, Hidalgo Diaz J J, Prunières G, Pire E, Taleb C, Honecker S, Bellemère P, Fontaine C, Liverneaux P A
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
Hand Surg Rehabil. 2017 Apr;36(2):122-126. doi: 10.1016/j.hansur.2016.12.007. Epub 2017 Feb 16.
Diagnosing rupture of the radial collateral ligament (RCL) of the finger metacarpophalangeal (MCP) joints is difficult. The aim of this cadaver study was to validate a rotational test for the MCP after RCL transection. With the MCP and proximal interphalangeal joints in flexion, rotation along the axis of the proximal phalanx was applied through an extended distal interphalangeal joint to 36 cadaver fingers. Each finger's pulp described an arc of pronation and supination that was noted on the palm. The test was repeated three times: before transection, after transection of the proper collateral ligament (CL) and after transection of both the proper and accessory CLs. Rotational arcs were measured in pronation and supination. Mean length of the pronation arc after transection of the main RCL was 17.53mm, while it was only 12.41mm before transection for the supination arc. Mean length of the pronation arc after transection of both CLs was 22.83mm compared to only 11.93mm before transection. Our results show a significant difference in pronation stability of the MCP joint after transection of the RCL proper. We can conclude that this rotational stability test is a valid test for diagnosing RCL rupture in MCP joints.
诊断手指掌指（MCP）关节桡侧副韧带（RCL）断裂很困难。本尸体研究的目的是验证RCL横断后MCP关节的旋转试验。将MCP关节和近端指间关节屈曲，通过伸展的远端指间关节对36个尸体手指沿近端指骨轴线施加旋转。每个手指的指腹在手掌上描绘出旋前和旋后的弧线并记录下来。该试验重复三次：横断前、横断固有侧副韧带（CL）后以及横断固有和副CL后。测量旋前和旋后的旋转弧长度。横断主要RCL后旋前弧的平均长度为17.53mm，而横断前旋后弧的平均长度仅为12.41mm。横断两条CL后旋前弧的平均长度为22.83mm，而横断前仅为11.93mm。我们的结果显示，横断固有RCL后MCP关节旋前稳定性存在显著差异。我们可以得出结论，这种旋转稳定性试验是诊断MCP关节RCL断裂的有效试验。
