Rotational stability test for the diagnosis of radial collateral ligament rupture in the fingers: Anatomical study.
Diagnosing rupture of the radial collateral ligament (RCL) of the finger metacarpophalangeal (MCP) joints is difficult. The aim of this cadaver study was to validate a rotational test for the MCP after RCL transection. With the MCP and proximal interphalangeal joints in flexion, rotation along the axis of the proximal phalanx was applied through an extended distal interphalangeal joint to 36 cadaver fingers. Each finger's pulp described an arc of pronation and supination that was noted on the palm. The test was repeated three times: before transection, after transection of the proper collateral ligament (CL) and after transection of both the proper and accessory CLs. Rotational arcs were measured in pronation and supination. Mean length of the pronation arc after transection of the main RCL was 17.53mm, while it was only 12.41mm before transection for the supination arc. Mean length of the pronation arc after transection of both CLs was 22.83mm compared to only 11.93mm before transection. Our results show a significant difference in pronation stability of the MCP joint after transection of the RCL proper. We can conclude that this rotational stability test is a valid test for diagnosing RCL rupture in MCP joints.
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France. Electronic address: Philippe.liverneaux@chru-strasbourg.fr.
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Lazarus
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Hidalgo Diaz
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Prunières
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Pire
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Taleb
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Honecker
Hand Surgery Centre, SOS main, 44000 Nantes, France.
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Bellemère
Institute of Anatomy, faculté de médecine de Lille, 1, place de Verdun, 59045 Lille cedex, France.
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Fontaine
Department of Hand Surgery, SOS main, CCOM, University Hospital of Strasbourg, FMTS, University of Strasbourg, Icube CNRS 7357, 10, avenue Baumann, 67400 Illkirch, France.
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Liverneaux
D002102:Cadaver; D017885:Collateral Ligaments / Q000293:injuries*; D005383:Finger Injuries / Q000175:diagnosis*; D006801:Humans; D007593:Joint Instability / Q000175:diagnosis*; D008662:Metacarpophalangeal Joint / Q000293:injuries; D010808:Physical Examination / Q000379:methods*; D011403:Pronation; D012421:Rupture / Q000175:diagnosis*; D013484:Supination
Articulation métacarpo-phalangienne; Entorse; Laxity; Laxité; Ligament collatéral radial; Metacarpophalangeal joint; Radial collateral ligament; Sprain; Stability; Stabilité; Test