Li Shuo, Brooks Jeffrey J, Jacob Jubin, Ghasemiesfe Ahmadreza, Marrinan Greg B
Yale New Haven Health Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA.
Orthopedic Surgery and Sports Medicine Center, 166 Cherry Street, New Canaan, CT, 06610, USA.
Skeletal Radiol. 2018 Apr;47(4):593-596. doi: 10.1007/s00256-017-2820-5. Epub 2017 Nov 20.
The sagittal bands are a component of the extensor hood. They serve an important role in stabilizing the extensor tendon by forming a "check-rein" to radial-ulnar translation of the tendon over the metacarpal head, and extending the metacarpophalangeal (MCP) joint by virtue of attaching the extensor tendon to the palmar plate. Injury to the sagittal band is thought to cause extensor instability and subluxation to the contralateral side by disruption of this "check-rein" function, although recent evidence from cadaver studies suggests that ulnar sagittal band tear may be spared of extensor instability. As a case in point, we encountered a patient with surgically proven ulnar sagittal band tear, who did not have any extensor tendon subluxation or any limitation in motion. Intraoperative findings demonstrated a chronic-appearing ulnar sagittal band tear, indicating that chronic injury with fibrosis may stabilize the central band. Therefore, in patients with metacarpophalangeal pain without central tendon subluxation or limitation of motion, it remains important to raise the concern of sagittal band tear for appropriate treatment. We present the clinical course of this case, with radiological and operative findings, followed by a review of the relevant literature.
矢状带是伸肌帽的一个组成部分。它们通过形成一个“控制缰绳”来稳定伸肌腱，防止肌腱在掌骨头处发生桡尺侧移位，并通过将伸肌腱附着于掌板来伸展掌指（MCP）关节。矢状带损伤被认为会破坏这种“控制缰绳”功能，从而导致伸肌不稳定和向对侧半脱位，尽管最近尸体研究的证据表明尺侧矢状带撕裂可能不会出现伸肌不稳定。例如，我们遇到一名经手术证实为尺侧矢状带撕裂的患者，该患者没有任何伸肌腱半脱位或活动受限。术中发现显示为慢性的尺侧矢状带撕裂，表明伴有纤维化的慢性损伤可能使中央带稳定。因此，对于没有中央肌腱半脱位或活动受限的掌指关节疼痛患者，提高对矢状带撕裂的警惕对于进行适当治疗仍然很重要。我们介绍该病例的临床过程、影像学和手术结果，随后对相关文献进行综述。
