Dislocations and Ligament Injuries in the Digits

Surgical Techniques for Correction of Traumatic Hyperextension Instability of the Proximal Interphalangeal Joint: A Biomechanical Study

“…1,33 However, the rare situation arises when orthosis fabrication fails and symptomatic hyperextension instability of the PIP joint develops. 1,4,5,7,11,22 Bowers 2 proposed that hyperextension instability of the PIP joint was most likely to occur in the absence of bone injury owing to poor vascularity of the volar plate and consequential adverse effects on soft tissue healing to bone. A swanneck deformity can develop and lead to difficulty initiating finger flexion with painful snapping as the lateral bands slide over the condyles of the proximal phalanx.…”

“…A swanneck deformity can develop and lead to difficulty initiating finger flexion with painful snapping as the lateral bands slide over the condyles of the proximal phalanx. 1 If left untreated, the PIP joint may deteriorate over time.…”

“…1C). 1,19 Double lateral band transfer: The extensor apparatus was exposed through the dorsal incision. The radial and ulnar lateral bands were dissected from the central tendon approximately 1 cm proximal and 1 cm distal to the PIP joint leaving the proximal and distal ends intact.…”

“…Treatment of closed dislocations, in the absence of gross postreduction PIP joint instability, consists of a period of protected finger motion with extension block splinting of the PIP joint and/or finger buddy taping. 1 Despite general success with this treatment, a small number of patients may experience persistent dorsal instability of the PIP joint with pain, mechanical symptoms, and a swan-neck finger deformity. 1e5 Surgical techniques to address chronic, posttraumatic PIP joint hyperextension instability have been designed to create a check-rein against PIP joint hyperextension.…”

Ulnar Collateral Ligament Injuries of the Thumb

“…If the tissue is lacking in either length or quality, reconstruction should be undertaken in lieu of an inadequate repair. 50 As such, both the surgeon and patient must be prepared for the possibility that a reconstruction may need to be performed.…”