Proximity of Collateral Ligament Origin to the Axis of Rotation of the Proximal Interphalangeal Joint of the Finger

Abstract

Normal function of the proximal interphalangeal (PIP) joints of the fingers is essential to hand function.18 Loss of range of motion (ROM) in a single PIP joint can result in a significant reduction in overall hand function, 23 and preservation of PIP joint function following trauma to the hand has been demonstrated to significantly improve functional outcomes.6 A better understanding of the PIP joint and soft tissues that provide support to the joint is essential to clinical management decisions in medical/surgical treatment and in rehabilitation.Among the components of the PIP joint considered critical to its function are the collateral ligaments. Insufficiency of the collateral ligaments can result in pain and instability of the PIP joints and overall diminished hand function. 1,10,16,19,21 Collateral ligaments help guide the PIP

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

“…6 Eaton theorized that the origins of the PCL centered around the axis of rotation for the PIP joint and inferred that the both portions of the PCL were tight during flexion without considering the effect of the condylar tubercle of the proximal phalanx. That inference was supported by Loubert et al 22 At the same time, Loubert et al shared the viewpoint of Kuczynski that the PCL changes length as it passes across the condylar tubercle of the proximal phalanx, although the tension of the PCL during flexion was not actually determined in these studies. Current data show that the dorsal portion of the PCL lengthened significantly during flexion, whereas the volar portion of the PCL shortened significantly.…”

Change in the collateral and accessory collateral ligament lengths of the proximal interphalangeal joint using cadaveric model three-dimensional laser scanning

“…One weakness associated with using moulds of bony surfaces is the lack of supplementary structures surrounding the joint, which may alter bone positions (Dumont et al, 2008). Loubert et al (2007) assessed the anatomical characteristics of the PIP joint collateral ligaments, specifically the length of the origin of the collateral ligaments from the axis of rotation. They did not assess ligament length change through the joint range of motion.…”

“…PIP joints need to be immobilized straight or nearly straight to avoid stiffness due to secondary collateral ligament contracture (Dzwierzynski et al, 1996; Liodaki et al, 2015; Loubert et al, 2007).…”

Management of the Stiff Finger

“…The tension in the collateral ligament changes very little as the PIP joint moves. 12 Similar to the MCP joint, the volar plate of the PIP joint is composed of two portions: a fibrous and a membranous portion. The volar plates of PIP joints are thinner than at the MCP level for most fingers.…”