Acute dislocation of the extensor digitorum communis tendon at the metacarpophalangeal joint. A report of five cases.

Araki, Satoshi; Ohtani, T; Tanaka, Tatsuro

doi:10.2106/00004623-198769040-00021

Cited by 63 publications

(33 citation statements)

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“…These injuries traditionally have been treated with repair or reconstruction of the affected sagittal band. [1][2][3][4][5] There is disagreement about the mechanism of injury. Boyes 6 attributed sagittal band injury to forced finger flexion with the wrist flexed and ulnarly deviated.…”

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confidence: 99%

Closed Treatment of Nonrheumatoid Extensor Tendon Dislocations at the Metacarpophalangeal Joint

Catalano

Gupta

Ragland

et al. 2006

The Journal of Hand Surgery

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confidence: 99%

Closed Treatment of Nonrheumatoid Extensor Tendon Dislocations at the Metacarpophalangeal Joint

Catalano

Gupta

Ragland

et al. 2006

The Journal of Hand Surgery

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“…4,6 Radial subluxation has been described previously as occurring in athletes after trauma in five cases, 3 with one other traumatic case of radial dislocation of the long finger described in the literature as occurring after 'flicking a spider' from an arm. 1 A congenital case has also been reported. 5 It is interesting to note that in the study by Hame and Melone, three of the five affected fingers were the small finger.…”

Section: Discussionmentioning

confidence: 95%

Radially subluxated extensor tendons after a karate demonstration

Farrar

Povlsen

2007

Injury Extra

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Traumatic disruption of the extensor tendon mechanism over the metacarpophalangeal joins has become commonly termed as 'boxer's knuckle', with the literature focussing on boxing injuries. Descriptions of the mechanism of tendon subluxation have concentrated on damage to the sagittal band, with ulnar subluxation due to radial sagittal band disruption being the focus. Traumatic radial subluxation has been reported previously, 3 although the mechanism of its occurrence has not being fully uncovered. It has been suggested that boxers should be carefully instructed on good punching technique in order to avoid these injuries. 3 We describe a case of boxer's knuckle in a karate instructor, with a demonstration of good punching technique resulting in radial subluxation of the extensor tendons of the index and long fingers over the metacarpophalangeal joints. Written informed consent was received from the patient described in this report. HistoryA 37-year-old martial arts instructor damaged his dominant right hand whilst demonstrating good punching technique to his class. The injury occurred at the time of one apparently standard well executed punch. He presented to clinic with difficulty forming a comfortable closed fist. ExaminationThe extensor tendon of the index finger could be felt to radially subluxate on flexion of the metacarpophalangeal joint. On flexing the metacarpophalangeal joint of the long finger, the extensor tendon could be felt to dislocate radially, with a palpable gap being felt on the ulnar side. ManagementUlnar sagittal band disruption of the index and long fingers was diagnosed and the option of surgical management offered to the patient. The risks involved were presented to him, including joint stiffness, scar tenderness and potential difficulties in continuing as a martial arts instructor, before proceeding to surgery.A transverse, dorsal incision across the second and third metacarpophalangeal joints was employed. Operative findings were complete ulnar sagittal band rupture of the long finger (see Fig. 1) with a capsular tear and partial ulnar sagittal band rupture of the index finger. Both extensor tendons were recentralised by repairing the ulnar sagittal bands with 2-O Injury Extra (2007) 38, 295-297

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“…The extensor tendon of the little finger was more stable and showed no dislocation or subluxation after complete rupture of the radial sagittal band even if the extensor tendon was stressed in flexion. It has been previously reported [25] that in the normal situation, the index and middle fingers show 10-15°of ulnar deviation which is felt to represent a predisposing Note extensor tendon (ET) is kept centered over MCP joint even if the extensor tendon was stressed in flexion factor for radial sagittal band rupture and dislocation [23,26]. In our opinion the reason for the systematic ulnar dislocation of the extensor tendon of the index is due to the absence of juncturae tendini in the first IMCS.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, it has also been previously reported that sagittal band injuries are most frequent in the middle finger [11,23,26,27], because of the relative prominence of the metacarpal head of the middle finger compared with the neighboring fingers. After partial rupture of the radial sagittal band of the middle finger there was no dislocation visualized in flexion but the tendon showed a significant ulnar subluxation after complete transection in comparison with the ring finger.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors advocate conservative treatment with splinting in full extension [5,19,25,26] albeit with less efficacy compared with patient groups receiving a direct repair of the torn dorsal hood with relocation of the extensor tendon [15-17, 20-22, 26, 28]. Some authors [15,16] suggest a trial of conservative treatment as a treatment option for acute subluxations or dislocations of the extensor mechanism in patients not requiring the performance of physically demanding repetitive activity and in those not requiring an early return to highly strenuous sports activities and a surgical repair in professional athletes.…”

Section: Discussionmentioning

confidence: 99%

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Functional anatomy of the dorsal hood or the hand: correlation of ultrasound and MR findings with cadaveric dissection

et al. 2009

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The main aim of this study was to provide an overview of the anatomy of the dorsal hood (DH) based on the dissection of sixteen cadaver hands, correlated with magnetic resonance (MR) and ultrasound findings. A secondary aim was to assess the function of components of the DH. Sixteen embalmed hands were evaluated by MRI and ultrasound before being dissected. Each hand was photographed during each stage of dissection. Secondly we evaluated the role of the different structures of the DH in the stability of the extensor tendon by transection of the different components alternatively at the ulnar and radial sides. MR, ultrasound, and dissection showed that the extensor tendon (ET) is stabilized by the sagittal band (SB) at the level of the metacarpophalangeal (MCP) joint and more distally by the transverse and the oblique bands, respectively. Transection of the radial SB of the second finger leads systematically to ulnar dislocation of the ET. The transection of the ulnar DH does not lead to instability of the ET. The SB is the most important structure of the DH in the stability of the ET at the MCP level. Rupture of the radial SB of the second finger leads systematically to ulnar dislocation of the ET.

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Acute dislocation of the extensor digitorum communis tendon at the metacarpophalangeal joint. A report of five cases.

Cited by 63 publications

References 0 publications

Closed Treatment of Nonrheumatoid Extensor Tendon Dislocations at the Metacarpophalangeal Joint

Closed Treatment of Nonrheumatoid Extensor Tendon Dislocations at the Metacarpophalangeal Joint

Radially subluxated extensor tendons after a karate demonstration

Functional anatomy of the dorsal hood or the hand: correlation of ultrasound and MR findings with cadaveric dissection

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