Anatomy and Biomechanics of the Finger Proximal Interphalangeal Joint

Pang, Eric Quan; Yao, Jeffrey

doi:10.1016/j.hcl.2017.12.002

Cited by 31 publications

(15 citation statements)

References 23 publications

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“…In addition to the flexion–extension in the sagittal plane, PIPJ kinematics includes abduction–adduction, axial rotation, and sagittal rotation [26]. However, the proposed PIPJ implant was based on Hillberry’s RCJ design, which reproduced only 1-DOF of motion, namely flexion–extension, in sagittal plane.…”

Section: Discussionmentioning

confidence: 99%

“…However, removal of a substantial amount of proximal phalanx bone stock is necessary during surgery to achieve the proximal position of the RCJ surface proximal to the neck of the proximal phalanx. In addition, PIPJ could become unstable as a result of injury to the collateral ligament during implantation [26]. Therefore, we included a condition in the constrained optimization algorithm requiring the tangential line extending from the dorsal and volar sides of the RCJ surface to be positioned distal to the dorsal infliction point and volar vertex of the proximal phalangeal head.…”

Section: Discussionmentioning

confidence: 99%

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Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

et al. 2019

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Background The aims of this study were to propose a novel implant design for the proximal interphalangeal joint (PIPJ) of the hand using a rolling contact joint (RCJ) mechanism and to derive an optimal implant design based on human PIPJ kinematics. Methods In total, 10 participants with normal PIPJs were enrolled in this study. True lateral finger radiographs were obtained in 10° increments from 0º (full extension) to 120° flexion of PIPJ. Radiographs were used to determine the average center of rotation, which formed the basis of a mathematical expression of the PIPJ kinematics. The variations in extensor tendon excursions in relation to the range of motion of PIPJ were determined using results from previous cadaveric studies. As the next step, a PIPJ implant design using an RCJ mechanism that was most consistent with the mathematically expressed PIPJ kinematics and tendon excursions was determined using a constrained optimization algorithm. Results The final proposed PIPJ implant had a relatively constant center of rotation over the entire PIPJ range of motion among the participants. In addition, the extensor tendon excursions of the proposed implant as applied to the phalangeal bones were similar to those of the human tendon. The proposed PIPJ implant achieved an acceptable position of the RCJ surface on the proximal and middle phalanges, which was derived from the constrained optimization algorithm. Conclusions A novel PIPJ implant design using an RCJ mechanism demonstrated acceptable outcomes in terms of PIPJ human kinematics and tendon excursions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

et al. 2019

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“…The true and accessory collateral ligaments, volar plate, and extensor and flexor tendons serve as the soft-tissue stabilizers 2. The PIP joint has motion in the axial, coronal, and sagittal planes and is thus more than a simple hinge 10. Bony anatomy gives lateral stability in full extension, whereas in flexion the joint stability and integrity relies mainly on the soft-tissue stabilizers 9.…”

Section: Anatomymentioning

confidence: 99%

“…2 The PIP joint has motion in the axial, coronal, and sagittal planes and is thus more than a simple hinge. 10 Bony anatomy gives lateral stability in full extension, whereas in flexion the joint stability and integrity relies mainly on the softtissue stabilizers. 9 In flexion, the middle phalanx supinates, which originates from slight asymmetry between the proximal phalangeal condyles.…”

Section: Anatomymentioning

confidence: 99%

Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures

Nordback

Waris²

2021

Techniques in Hand &Amp; Upper Extremity Surgery

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Proximal interphalangeal joint injuries are common and are a major risk for functional deficits of the finger that affect range of motion and grip strength. Impacted intra-articular fractures and fracture dislocations of the middle phalanx base are challenging to treat because of troublesome joint reduction and difficulties in achieving articular congruity. Although treatment algorithms have been published, the anatomically delicate proximal interphalangeal joint often remains incomplete in function and may result in post-traumatic pain, stiffness, and osteoarthritis. This article describes a percutaneous intramedullary reduction technique for impacted middle phalanx fractures as a treatment option to achieve articular congruity with minimal surgical trauma. The reduction technique may be considered for selected patients with impacted fractures of the base of the middle phalanx with or without joint dislocation.

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“…In hands, both the proximal (PIPJ) and distal (DIPJ) interphalangeal joints are bound by collateral ligaments on the radial and ulnar sides, extensor tendons like the central slip dorsally, and a ligamentous volar plate on their palmar surface. 1 These structures all contribute to PIPJ stability and movement; so injury to any of them can cause significant joint instability and, untreated, chronic finger deformity. 2 Extensor tendon injuries generally are more common and functionally limiting than flexor tendon injuries.…”

mentioning

confidence: 99%

Simultaneous Central Slip and Volar Plate Injuries at PIP Joint: A Novel Therapeutic Approach

Alotaibi

AlMarshad

Alzahrani

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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In hands, both the proximal (PIPJ) and distal (DIPJ) interphalangeal joints are bound by collateral ligaments on the radial and ulnar sides, extensor tendons like the central slip dorsally, and a ligamentous volar plate on their palmar surface. 1 These structures all contribute to PIPJ stability and movement; so injury to any of them can cause significant joint instability and, untreated, chronic finger deformity. 2 Extensor tendon injuries generally are more common and functionally limiting than flexor tendon injuries. [2][3][4] Nonetheless, nondisplaced, noncomminuted finger fractures usually are treated nonsurgically. 5 Volar plate fractures and central slip injuries typically occur secondary to entirely different mechanisms, the former typically caused by PIPJ hyperextension, a crush injury, or axial loading (eg, someone "jams" their finger). The joint becomes unstable and is at risk of further subluxation. Such injuries are more common in youths, often attributed to sports. 6 Untreated, a swan-neck deformity can result. Typical management of nondisplaced volar plate fractures involves extension-block splinting, 7 in which the PIPJ is usually held in some degree of flexion to facilitate volar-plate healing and prevent hyperextension. Conversely, central slip injuries are caused by hyperflexion, or from direct blunt or penetrating trauma, typically to the middle phalanx. 7 Contrary to volar plate instability, central slip disruption causes the PIPJ to drop into flexion and, when untreated, can result in a boutonnière deformity.Although both injuries are common, it is highly infrequent to find them simultaneously in the same joint. 8 Despite protocols existing for each of these injuries occurring separately, 6,9 no protocol yet exists guiding management

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Anatomy and Biomechanics of the Finger Proximal Interphalangeal Joint

Cited by 31 publications

References 23 publications

Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

Novel implant design of the proximal interphalangeal joint using an optimized rolling contact joint mechanism

Percutaneous Intramedullary Reduction Technique for Impacted Middle Phalanx Base Fractures

Simultaneous Central Slip and Volar Plate Injuries at PIP Joint: A Novel Therapeutic Approach

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