Biomechanical Differences of the Proximal Interphalangeal Joint Volar Plate During Active and Passive Motion: A Dynamic Ultrasonographic Study

Saito, Susumu; Suzuki, Shigehiko; Suzuki, Yoshihisa

doi:10.1016/j.jhsa.2012.03.004

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…Using ultrasonography, Saito et al 19 found that during passive flexion the volar elevation of the volar plate could not be observed and the flattened configuration was maintained. Therefore, the length of the middle and proximal portions of ACL change little through the motion arc.…”

Section: Discussionmentioning

confidence: 99%

“…According to the dynamic ultrasonographic study by Saito et al, 19 the volar plate of the PIP joint maintained the flat structure throughout the motion arc and did not elevate in passive flexion. We assumed the lateral thickness of volar plate as 0.22 mm based on the studies of Kömürcü et al 20 and Lee et al 18 The insertions of the ACL at the volar plate were modeled as 0.22 mm higher than the bone surface of phalanx.…”

Section: Measurement Of Lengths Of Ligamentsmentioning

confidence: 97%

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In Vivo Length Changes of the Proximal Interphalangeal Joint Proper and Accessory Collateral Ligaments During Flexion

Chen

Tan

Zhang

2015

The Journal of Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Measurement Of Lengths Of Ligamentsmentioning

confidence: 97%

In Vivo Length Changes of the Proximal Interphalangeal Joint Proper and Accessory Collateral Ligaments During Flexion

Chen

Tan

Zhang

2015

The Journal of Hand Surgery

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“…The PIP joint has a stout volar plate that distributes joint fluid during joint flexion and extension, thus keeping the joint always lubricated during motion. Unfortunately, the DIP joint does not have such a mechanism [2, 13].…”

Section: Discussionmentioning

confidence: 99%

Curvatures of the DIP Joints of the Hand

Graham

Goitz

Kaufmann

2014

Hand (New York, N,Y.)

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Background The distal interphalangeal (DIP) joints of the hand are highly susceptible to osteoarthritis and trauma. Surgical treatment options mandate accurate characterization of their osseous anatomy; however, there are few studies that describe this. We describe the curvatures of the DIP joints by measuring the bone morphology using advanced imaging and modeling methods. Methods The fingers of 16 right hand fresh frozen human cadavers were analyzed. Fingers showing signs of DIP joint arthritis were excluded. The fingers were scanned using microtomography (microCT). Measurements of the bony morphology were made using models created from the scans. Results In each finger, there is no statistically significant difference between the radii of curvature of the ulnar and radial condyles of the middle phalanx head. Conversely, the radius of curvature of the distal phalanx ulnar groove is significantly greater than that of the radial groove. The radii of curvature of the groove of the distal phalanx and the condyles of the middle phalanx displayed nonconformity with disparity increasing from the index to small fingers. Remarkably, the radius of curvature of the distal phalanx central ridge and the mean radius of the middle phalanx condyles are essentially the same. Conclusion The purpose of this study is to gain better insight into the DIP joints of the hand. The asymmetry between the distal phalanx grooves and the middle phalanx condyles suggests that there may be a translational component to DIP joint motion. Our understanding of morphology may lend insight into the biomechanics and disease progression within the DIP joints.

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“…In order to address the challenge of diagnosing A3 pulley ruptures, a novel indirect approach via investigation of the volar plate was proposed. Using ultrasound, Saito et al [22] were able to visualize a sliding, elevating and rolling movement in the VP recess during finger flexion. Bayer et al [8,23] were able to show a reduction of the VP translation distance as well as an augmentation of the VP tendon distance as indirect signs of A3 pulley rupture using MRI.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of A3 Pulley Injuries Using Ultrasound

Schöffl

Deeg

Lutter

et al. 2018

Sportverletz Sportschaden

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Rationale and Objectives Pulley ruptures are the most common injuries in sport climbing. Ruptures of the A2 and A4 pulleys have been studied extensively, and ultrasound has proven to be a highly sensitive and specific tool for their diagnosis. However, the correct diagnosis of A3 pulley ruptures continues to be a challenge. Therefore, we investigated a novel approach to this pathology. Material and Methods Eighteen fingers from nine different human cadavers were examined using high-resolution, dynamic ultrasound before and after being subjected to different combinations of singular and multiple iatrogenic pulley ruptures in a standardised fashion. Special attention was paid to the behaviour of the volar plate (VP) with respect to the proximal interphalangeal joint (PIP) and the flexor tendons before and after pulley rupture. Results Injuries to the A2 and A4 pulleys were diagnosed via ultrasound with sensitivities of 90 % and 94 % and specificities of 100 % and 97 %, respectively. A direct visualisation of the A3 pulley was achieved in 61 % of the fingers. The VP became significantly thicker and shorter during finger flexion as well as after A3 pulley rupture. The distance between tendon and VP became significantly more pronounced after A3 pulley rupture. For distances greater than 0.9 mm between VP and tendon, a sensitivity of 76 % and a specificity of 94 % were achieved for determining A3 pulley ruptures. Conclusion The distance measurement between VP and tendon was found to be a valid indirect method for the diagnosis of A3 pulley ruptures. This approach is the first ultrasound method for accurately diagnosing A3 pulley ruptures.

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Biomechanical Differences of the Proximal Interphalangeal Joint Volar Plate During Active and Passive Motion: A Dynamic Ultrasonographic Study

Cited by 10 publications

References 20 publications

In Vivo Length Changes of the Proximal Interphalangeal Joint Proper and Accessory Collateral Ligaments During Flexion

In Vivo Length Changes of the Proximal Interphalangeal Joint Proper and Accessory Collateral Ligaments During Flexion

Curvatures of the DIP Joints of the Hand

Diagnosis of A3 Pulley Injuries Using Ultrasound

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