Radial Collateral Ligament Injury of the Index Metacarpophalangeal Joint: An Underreported but Important Injury

Gaston, R. Glenn; Lourie, Gary M.; Peljovich, Allan E.

doi:10.1016/j.jhsa.2006.05.015

Cited by 59 publications

(60 citation statements)

References 15 publications

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“…In spite No discernable endpoint to ulnarly applied stress This grading system has been published in the text of Gatson et al [4] a Laxity was measured by testing the involved index finger in full flexion with ulnar directed stress and comparing it to the contralateral digit of this result, we continue to advocate the need for an early diagnosis and treatment to allow for a better outcome [10]. The RCL rupture was repaired with a Mitek bone suture anchor, which has been used in previous cases of repair of the collateral ligaments [10,17,18,21,24,29,37]. This anchor is a titanium alloy with its prongs composed of titanium and nickel [16].…”

Section: Discussionmentioning

confidence: 99%

“…In this time period, the least commonly reported was a RCL injury of the index MCP joint of which no cases were reported. In full review of the literature, only 32 patients have been reported with this specific injury of the index finger; three patients have been reported in a case study in 1989, three more in a larger study of RCL injuries to all digits in 1998, 14 additional patients in an index RCL study in 2006, and a final 12 patients in a similar report of index RCL injuries in 2007 [7,10,17,30]. The early diagnosis of these injuries is important due to the less successful outcomes seen with late treatment [10].…”

Section: Introductionmentioning

confidence: 99%

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Index Radial Collateral Ligament Repair with Titanium Mini-Suture Anchor: Osteolysis Complication of an Underreported Injury

Mirza

Reinhart

Bove

2009

Hand (New York, N,Y.)

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We are reporting on a case of an index radial collateral ligament tear repaired with a titanium Mitek bone suture anchor. The development of cystic radiographic changes and increased pain and weakness led to suture anchor removal at 10 months post-repair. Periprosthetic osteolysis due to titanium-induced osteoclastogenesis and micromotion was suspected to be the cause. This case report provides a dual focus by stressing the importance of the diagnosis and treatment of this underreported ligament tear and highlighting our osteolysis complication via the mechanism of titanium-induced osteoclastogenesis for future therapeutic preventive measures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Index Radial Collateral Ligament Repair with Titanium Mini-Suture Anchor: Osteolysis Complication of an Underreported Injury

Mirza

Reinhart

Bove

2009

Hand (New York, N,Y.)

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“…Complete injury to the RCL of the index finger can be persistently symptomatic because of its crucial role in providing stability for key pinch [8,10]. The small finger can remain symptomatic because of its location as a border digit, it is subject to extrinsic ulnar-directed forces, and lacks an adjacent digit to serve as a buttress.…”

Section: Discussionmentioning

confidence: 99%

“…It may be the true incidence is underreported or under-recognized [17]. Partial ligament injuries can be treated nonoperatively and managed successfully with a period of immobilization [10]. However, there is little data to guide the management of complete tears, with most reports focusing on the radial collateral ligament (RCL) of the index finger.…”

Section: Introductionmentioning

confidence: 99%

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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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Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance

Draghi

Gitto

Bianchi³

2018

J of Ultrasound Medicine

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Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. This review article aims to provide physicians with guidelines for sonographic assessment of the collateral ligaments of the MCP and IP and related injuries. Sonographic features of ligament injuries ranging from sprains and partial-thickness tears to full-thickness tears are described. Specific lesions of the ulnar collateral ligament of the thumb MCP joint, such as gamekeeper's thumb, skier's thumb, and Stener lesions, are also included. In conclusion, sonography is effective in evaluating the collateral ligaments of the MCP and IP joints and related injuries and represents a valuable tool for diagnosis.

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Radial Collateral Ligament Injury of the Index Metacarpophalangeal Joint: An Underreported but Important Injury

Cited by 59 publications

References 15 publications

Index Radial Collateral Ligament Repair with Titanium Mini-Suture Anchor: Osteolysis Complication of an Underreported Injury

Index Radial Collateral Ligament Repair with Titanium Mini-Suture Anchor: Osteolysis Complication of an Underreported Injury

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

Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance

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