Institut Montpelliérain de la Main et du Membre Supérieur, Clinique Saint-Roch, 560 Avenue du Colonel Pavelet, 34070 Montpellier, France.
Service de Chirurgie de la Main, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67200 Strasbourg, France.
Hand Surg Rehabil. 2022 Jun;41(3):347-352. doi: 10.1016/j.hansur.2022.01.008. Epub 2022 Feb 5.
Severe collateral ligament sprain of the metacarpophalangeal joint (MCP) of the fingers is rare. Clinical examination is mandatory to diagnose severity. The purpose of our study was to validate a clinical sign for MCP joint laxity: the spontaneous lateral laxity sign (SLLS), recently described by Meyer et al. to diagnose severe MCP radial collateral ligament (RCL) sprain, with a comparison with the already validated rotational laxity test (RLT). SLLS and RLT were assessed before RCL transection, after RCL transection and after RCL repair on 40 long fingers in 10 fresh thawed cadavers. SLLS was performed with the elbow on the table, wrist in 70° flexion, in neutral pronation-supination, hands drooping passively with the dorsal side toward the examiner and the ulnar side toward the table. The MCP joints were at rest, in passive slight extension. Positive results were defined as an overlap of the damaged finger on the next, or as an increased abduction of the little finger. Correlation between the two tests was calculated. SLLS was positive in 0% of cases before RCL transection, 100% after transection and 0% after repair. Mean arcs of pronation and supination on RLT were 16 and 19.5 mm before section, 24 and 33 mm after section (52% and 69% increase compared to preoperative data), and 17 and 21 mm after repair (7% and 8% increase). Correlation between the two tests was 100%. The spontaneous lateral laxity sign is a simple and reliable clinical sign for diagnosing complete long-finger MCP RCL tears requiring surgery. LEVEL OF EVIDENCE: : III, case-control study.
手指的掌指关节（MCP）严重侧副韧带扭伤较为罕见。临床检查是诊断严重程度的必要手段。我们的研究目的是验证一种用于诊断 MCP 关节松弛的临床征象：Meyer 等人最近描述的自发性侧向松弛征（SLLS），用于诊断严重的 MCP 桡侧副韧带（RCL）扭伤，并与已经验证的旋转松弛试验（RLT）进行比较。在 10 个新鲜解冻尸体的 40 个长指上，分别在 RCL 切断前、切断后和修复后评估 SLLS 和 RLT。SLLS 在肘部放在桌子上、腕部弯曲 70°、中立旋前-旋后、手部被动悬垂使背侧朝向检查者、尺侧朝向桌子的情况下进行。MCP 关节在休息状态下处于轻微被动伸展。阳性结果定义为损伤手指与相邻手指重叠，或小指外展增加。计算了两种测试之间的相关性。在 RCL 切断前，SLLS 在 0%的病例中为阳性，在切断后 100%为阳性，在修复后 0%为阳性。RLT 上的旋前和旋后平均弧为 16 和 19.5 mm，在切断后为 24 和 33 mm（与术前数据相比增加了 52%和 69%），在修复后为 17 和 21 mm（与术前数据相比增加了 7%和 8%）。两种测试之间的相关性为 100%。自发性侧向松弛征是一种简单可靠的临床征象，可用于诊断需要手术治疗的完全长指 MCP RCL 撕裂。证据水平：III，病例对照研究。
