Early surgical treatment for collateral ligament rupture of metacarpophalangeal joints of the fingers

Delaere, O.; Suttor, Patrick M.; Degolla, Regis; Leach, Robert E.; Pieret, Phillipe J.

doi:10.1053/jhsu.2003.50048

Cited by 52 publications

(44 citation statements)

References 10 publications

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“…Identification of such lesions is important because detection of an associated osteochondral injury may require surgical intervention (76). MR imaging may demonstrate a partial or complete ligament tear, bone marrow edema, or fracture.…”

Section: State Of the Art: Sports-related Hand And Wrist Injuriesmentioning

confidence: 99%

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Cockenpot¹,

Lefebvre²,

Demondion³

et al. 2016

Radiology

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Hand and wrist injuries are common occurrences in amateur and professional sports and many of them are sport-specific. These can be divided into two categories: traumatic injuries and overuse injuries. The aim of this article is to review the most common hand and wrist sports-related lesions. Acute wrist injuries are predominantly bone fractures, such as those of the scaphoid, hamate hook, and ulnar styloid. Ligament lesions are more challenging for radiologists and may lead to carpal instability if undiagnosed. Overuse wrist injuries are mainly represented by tendinous disorders, with De Quervain syndrome and extensor carpi ulnaris tendon disorders being the most common among them; however, there are other possible disorders such as impaction syndromes, stress fractures, and neurovascular lesions. Finally, finger lesions, including closed-tendon injuries (mallet and boutonniere injuries, jersey finger, and boxer's knuckle), flexor pulley injuries, and skier's thumb, should also be detected. (©) RSNA, 2016 Online supplemental material is available for this article.

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Section: State Of the Art: Sports-related Hand And Wrist Injuriesmentioning

confidence: 99%

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Cockenpot¹,

Lefebvre²,

Demondion³

et al. 2016

Radiology

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show abstract

“…It may be, in part, that these injuries are underreported. In fact, Delaere et al reported that 1 in 1,000 injuries to the hand included MPJ collateral ligament injuries, and 39 % of these involved the fingers [6]. Treatment of collateral ligament disruptions is based upon injury severity and acuity.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that 1 in 1,000 hand injuries involve MPJ collateral ligaments; 39 % of these involve the fingers and the remainder involve the thumb [6]. It may be the true incidence is underreported or under-recognized [17].…”

Section: Introductionmentioning

confidence: 99%

Outcomes after Repair of Subacute-To-Chronic Grade III Metacarpophalangeal Joint Collateral Ligament Injuries in Fingers are Suboptimal

Wong¹,

Lutsky

Beredjiklian

2013

Hand (New York, N,Y.)

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Purpose Although injury to the collateral ligaments of the metacarpophalangeal joint (MPJ) of the fingers is less common than corresponding injuries in the thumb, similar disability may result from chronic untreated injuries. We evaluated injury characteristics and the outcome after primary repair of subacute to chronic grade III collateral ligament injuries of the MPJs of the fingers. Methods We retrospectively reviewed all patients who underwent primary repair of a finger MPJ collateral ligament over a 3-year period. Twenty-five digits in 23 patients with subacute to chronic injuries were identified, all of which had complete MPJ collateral ligament tear. Postoperatively, we assessed disability using DASH scores and evaluated joint stability, range of motion, and grip strength. These measures were compared to preoperative data to assess results. Post hoc analysis was used to compare the level of disability between index and small radial collateral ligaments and other finger CL injuries. Results Intraoperative findings revealed complete tears in all cases and all ligaments were of sufficient quality to permit primary repair using a suture anchor. The average preoperative DASH score was 40 (range 17-77) in 7 patients (nine fingers) where this was available. Postoperative DASH scores were available in 19 patients (21 fingers). The average postoperative DASH score was 19 (range 0-65). In the subgroup of patients with preoperative and postoperative DASH scores, there was no statistically significant difference after surgery (preop DASH 39.1 vs. postop DASH 23.8, p =0.17). The average grip strength as a percentage of the contralateral hand was 68 % (range 32-100 %). The average postoperative MPJ arc of motion was 75°(range 50-90°). Post hoc analysis showed statistically significant higher postoperative DASH scores among small finger RCL repairs compared to other finger CL repairs (p =0.007). Discussion Primary repair of complete MPJ collateral ligament injuries of the fingers may be performed in the subacute to chronic setting. Although joint stability was restored, patients continued to have decreased grip strength and residual disability.

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“…Grade 1 injuries (patient 1) were treated with a protective splint with the MCP joint in 30°to 45°of flexion, as recommended by others, 5,9 and slight radial deviation for 3 weeks while allowing the patient to perform flexion extension exercises 3 times daily with the index finger buddy taped to the middle finger. This was followed by buddy taping alone for an additional 3 weeks.…”

Section: Methodsmentioning

confidence: 99%