Radial collateral ligament injury of the index metacarpophalangeal joint: An underreported but important injury

被引:32
作者
Gaston, R. Glenn [1 ]
Lourie, Gary M. [1 ]
Peljovich, Allan E. [1 ]
机构
[1] Hand & Upper Extrem Ctr Georgia, Atlanta Med Ctr, Atlanta, GA 30327 USA
来源
JOURNAL OF HAND SURGERY-AMERICAN VOLUME | 2006年 / 31A卷 / 08期
关键词
radial collateral ligament; index finger;
D O I
10.1016/j.jhsa.2006.05.015
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: To present the results of various treatment modalities based on injury grade of radial collateral ligament (RCL) injuries to the index metacarpophalangeal (MP) joint. Methods: Fourteen patients were evaluated (4 male, 10 female) with RCL injuries to the index MP joint. We defined injuries as Grade 1 (tenderness over RCL, no instability), grade 2 (laxity compared to the contralateral digit with a definite endpoint), or grade 3 (laxity without endpoint). Early presentation is defined as less than four weeks and late greater than four weeks. Results: The average follow up was 24 months. Grade I-II injuries seen early (4 patients) treated with 4-6 weeks splinting had excellent results (normal ROM, stable pinch, pain free). There were no Grade I-II injuries seen late. Of Grade III injuries seen early (2 patients), attempted treatment in a removable splint was unsuccessful secondary to patient noncompliance; subsequently requiring primary repair of the collateral ligament which resulted in good outcomes. No Grade III injury seen early had attempted treatment in a cast. Eight patients presented late with Grade III injuries (4 elected for surgical intervention, 4 for nonsurgical management) and all had fair or poor outcomes. Conclusions: The significance of this injury remains underestimated and requires a high index of suspicion. Stable injuries seen early should be treated with prompt immobilization. Casting may be more effective than a removable splint. Grade III injuries seen early could possibly be treated with cast immobilization though close follow up is mandatory as surgical repair may be necessary in the high demand hand. All Grade III injuries treated late yielded fair to poor results requiring tendon reconstruction or fusion with significant alteration in hand function.
引用
收藏
页码:1355 / 1361
页数:7
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