Rubin J, Bozentka D J, Bora F W
Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, USA.
J Hand Surg Br. 1996 Oct;21(5):614-6. doi: 10.1016/s0266-7681(96)80142-2.
Four non-invasive tests for central slip integrity were analysed using 20 fresh frozen cadaver fingers. A pre-boutonnière deformity was simulated by dividing the central slip. A passively correctable boutonnière was simulated by dividing the central slip, triangular ligament and oblique fibres of the extensor expansion. The test described by Boyes, which evaluates distal interphalangeal joint flexion, was found not to be reliable for the diagnosis of either injury. The test described by Elson, which evaluates distal interphalangeal joint rigidity while actively extending the flexed proximal interphalangeal joint, was the only manoeuvre which was able to discern central slip integrity in both simulated injuries. The central slip tenodesis test and testing resistance of active proximal interphalangeal joint extension should be performed with the proximal interphalangeal joint in flexion to weaken the effectiveness of the lateral bands.
使用20根新鲜冷冻的尸体手指，对四种检测中央束完整性的非侵入性测试进行了分析。通过切断中央束来模拟纽扣指畸形前期。通过切断中央束、三角韧带和伸肌扩张部的斜纤维来模拟可被动矫正的纽扣指。发现Boyes描述的评估远侧指间关节屈曲的测试对于两种损伤的诊断均不可靠。Elson描述的在主动伸展屈曲的近侧指间关节时评估远侧指间关节僵硬程度的测试，是唯一能够辨别两种模拟损伤中中央束完整性的操作。中央束固定试验以及测试主动近侧指间关节伸展的阻力时，近侧指间关节应处于屈曲状态，以减弱侧束的作用。
