Morphometric anatomic study and clinical significance of the collateral ligaments of the thumb interphalangeal joint

We aimed to emphasize the clinical significance of the collateral ligaments of the thumb interphalangeal joint through a morphometric anatomical study. Our study was performed on the thumbs obtained from 10 fresh cadavers in Akdeniz University Faculty of Medicine Anatomy Department Laboratory. The collateral ligaments in the thumb interphalangeal joint were examined and morphometric analysis was carried out using MicroScribe G2X. It was observed that the collateral ligaments are made up of proper (pCL) and accessory (aCL) components. pCL extends from the dorsal surface of the proximal phalanx head to the palmar surface of the proximal end of the distal phalanx, while aCL extends obliquely from dorsal to palmar and from proximal to distal and attaches to the palmar plate. The mean vertical and transverse diameters of the collateral ligament in the proximal interphalangeal joint were 12±2 mm (10 mm min –14 mm max) and 3±1 mm (2 mm min – 4 mm max), respectively. Knowing the anatomy and morphometry of the collateral ligaments of the thumb interphalangeal joint will shed light on the surgical techniques that are to be applied in the reconstructions of injured ligaments.

PDF

___

1. Day CS, Ramirez MA. Thumb metacarpophalangeal arthritis: arthroplasty or fusion? Hand Clin. 2006;22:211–20.

2. Rehim SA, Chung KC. Applying evidence in the care of patients with rheumatoid hand and wrist deformities. Plast Reconstr Surg. 2013;132: 885–97.

3. Dilekci E, Ozkuk K, Kaki B. Assessment of the health workers’ knowledge and belief about rheumatic and musculoskeletal diseases and spa treatments: A descriptive study. Med-Science. Published Online: Oct 31, 2019.

4. Chacko AT, Rozental TD. The rheumatoid thumb. Hand Clin. 2008;24:307-14.

5. Figgie MP, Inglis AE, Sobel M, et al Metacarpalphalangeal joint arthroplasty of the rheumatoid thumb. J Hand Surg. 1990;15:210–6.

6. Ozsoy T, Oner Z, Oner S. An attempt to gender determine with phalanx length and the ratio of phalanxes to whole phalanx length in direct hand radiography. Med-Science. Published Online: September 4, 2019

7. Martinoli C, Perez MM, Bignotti B, et al. Imaging finger joint instability with ultrasound. Semin Musculoskelet Radiol. 2013;17:466-76.

8. Redler I, Williams JR. Rupture of a collateral ligament of the proximal interphalangeal joint of the fingers: analysis of eighteen cases. J Bone Joint Surg Am. 1967;49:322-6.

9. Rozmaryn LM. The collateral ligament of the digits of the hand: anatomy, physiology, biomechanics, injury, and treatment. J Hand Surg Am. 2017;42:904e915.

10. Kuczymski, K. The proximal interphalangeal joint: anatomy and causes of stiffness in the fingers. J Bone Joint Surg Br. 1968;50:656–63.

11. Curtis RM. Treatment of injuries of proximal interphalangeal joints of fingers. Curr Pract Orthop Surg. 1964;23:125-39

12. Kaplan EB. Functional and surgical anatomy of the hand. 2nd edition. Philadelphia: JB Lippincott Company, 1965:3945.

13. Bowers WH. The anatomy of the interphalangeal joints. In: Bowers WH, ed. The hand and upper limb. Vol 1. The interphalangeal joints. Edinburgh: Churchill Livingstone, 1987:2–13. ISBN-10:0443032165

14. Glickel SZ, Barron OA, Eaton RG. Dislocations and ligament injuries in the digits. In: Green DP, Hotchkiss RN, Pederson WC, editors. Green’s operative hand surgery. 4th ed. New York: Churchill Livingstone, 1999:772–5.

15. Allison DM. Anatomy of the collateral ligaments of the proximal interphalangeal joint. J Hand Surg Am. 2005;30:1026-31.

16. Kiefhaber TR, Stern PJ, Grood ES. Lateral stability of the proximal interphalangeal joint. J Hand Surg. 1986;11A:661–9.

17. Harris H, Joseph J. Variation in extension of the metacarpophalangeal and interphalangeal joint of the thumb. J Bone Joint Surg Br. 1949;31:547e559.

18. Edelstein DM. , Kardashian G and Lee SK. Radial collateral ligament injuries of the thumb. J Hand Surg. 2008;33:760-70.

19. Gluck JS,Balutis EC, Glickel SZ. Thumb ligament injuries. J Hand Surg. 2015;40:835-42.

20. Christopher J Dy, Scott M Tucker, Peter L Kok, et al. Anatomy of the radial collateral ligament of the index metacarpophalangeal joint. J Hand Surg. 2013;38:124-8.