Functional Anatomy of the Thumb Sagittal Band

Jaibaji, Moneer; Rayan, Ghazi M.; Chung, Kyu‐Rhim

doi:10.1016/j.jhsa.2008.01.039

Cited by 16 publications

(14 citation statements)

References 8 publications

(12 reference statements)

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“…This connection has been described by Jaibaji et al 17) The ulnar sagittal band provides a continuous fascial connection from the adductor tendon, the volar plate, and the A1 pulley to the thumb extensor tendons. When the MCP joint is flexed, the ulnar sagittal band moves distally.…”

Section: Discussionmentioning

confidence: 76%

“…This complex lies over the UCL of the thumb. 17) The study by Adler describes fibers connecting the UCL to the underlying joint capsule and the adductor aponeurosis superficially, and these soft tissue connections were apparent during our dissection. The adductor aponeurosis is often described or depicted as a discrete band over the ulnar side of the MCP joint.…”

Section: Discussionmentioning

confidence: 89%

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Can Physical Examination Create a Stener Lesion?

Lankachandra

Eggers

Bogener

et al. 2017

J Hand Surg Asian-Pac Vol

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Background: The purpose of this study is to determine whether a Stener lesion can be created while testing stability of the ulnar collateral ligament (UCL) of the thumb. Testing was performed in a manner that reproduced clinical examination. Methods: Six fresh frozen hand and forearm specimens underwent sequential sectioning of the accessory UCL, the proper UCL, and the ulnar sagittal band. Measurements of radial deviation of the metacarpophalangeal (MCP) joint were taken with the thumb in neutral rotation, pronation and supination, both with 0 degrees and with 30 degrees of flexion of the MCP joint. Visual examination was performed to assess the presence of a Stener lesion. Results: No Stener lesion was created in any position as long as the fascial origin of the ulnar sagittal band at the adductor pollicis longus remained intact. After creating a defect in the ulnar sagittal band, a Stener lesion was created in two specimens, but only when the thumb was flexed and supinated. Pronation provided more stability, and supination provided less stability, with one or both components cut, especially when testing at 30° of flexion. Compared to both components cut without flexion or rotation, there was a statistically significant difference in angulation with the 30 degrees of MCP joint flexion in both neutral rotation in supination. Conclusions: Performing a physical examination to assess the amount of instability of an ulnar collateral ligament injury did not create a Stener lesion if the exam was performed in a controlled, gentle manner with the thumb held without rotation. If the thumb is held in neutral rotation during the exam, an iatrogenic Stener lesion should not be created.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 89%

Can Physical Examination Create a Stener Lesion?

Lankachandra

Eggers

Bogener

et al. 2017

J Hand Surg Asian-Pac Vol

View full text Add to dashboard Cite

show abstract

“…A recent cadaveric study showed that the radial component of the thumb sagittal band is more important for EPL tendon stabilization at the MCP joint than its ulnar component and identified a triangular-shaped retinacular membrane between the EPL and extensor pollicis brevis tendons proximal to the MCP joint. 10 In the current case, we plicated the radial sagittal band and the triangular-retinacular membrane between the EPL tendon and extensor pollicis brevis tendon and thus restored full extension of the thumb. Previous reports have also shown that repairing aponeurosis and centralizing extensor tendons improves thumb extension in nonrheumatoid cases.…”

Section: Discussionmentioning

confidence: 76%

Ulnar Subluxation of a Ruptured EPL Tendon at the Metacarpophalangeal Joint: Case Report

Gong¹,

Chung²,

Oh³

et al. 2009

The Journal of Hand Surgery

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“…4 Following a laceration, this expansion prevents proximal migration of the EPL, with the sagittal bands having a similar effect to extensor digitorum communis of the finger. 1 Jaibaji et al 13 investigated the functional anatomy of the thumb sagittal band using 24 cadaveric amputated specimens. Jaibaji et al 13 also report that proximal migration during isolated and composite MP and IP joint flexion is restricted at zone II due to the thenar muscles inserting onto the EPL expansion.…”

Section: Introductionmentioning

confidence: 99%

“…1 Jaibaji et al 13 investigated the functional anatomy of the thumb sagittal band using 24 cadaveric amputated specimens. Jaibaji et al 13 also report that proximal migration during isolated and composite MP and IP joint flexion is restricted at zone II due to the thenar muscles inserting onto the EPL expansion. Given these are intrinsic muscles, tension on the repair will not change with alteration of the wrist position.…”

Section: Introductionmentioning

confidence: 99%

Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

Veenendaal

Moate

2011

Hand Therapy

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Introduction. Forearm-based splints have been traditionally used for extensor pollicis longus (EPL) tendon repairs for zones T II-T V (T is used to represent thumb extensor tendon zones). Limited literature exists on hand-based splinting in the rehabilitation of zone T II EPL tendon repairs. This retrospective review of five case studies highlights the anatomical justification and the outcome of rehabilitation of zone T II EPL surgical repairs using a static hand-based thumb extension splint. Methods. In this study, five patients were retrospectively reviewed. All patients attended hand therapy for initial treatment within three days postoperatively. The postoperative interphalangeal joint mobilization regimen utilized in this study was early active motion (EAM). Outcomes measured in the study were reliable and valid, including goniometry measurement at week 4, week 6 and week 8 postoperatively for range of motion, total active motion (TAM), Dargan's criteria assessing extensor lag and White's assessment of interphalangeal joint range of motion. Results. The results demonstrated that a hand-based splint did not create undue stress on the EPL tendon repair, as there was no incidence of rupture. Hyperextension of EPL was within 88 compared with the noninjured thumb. 'Excellent' and 'good' categories were achieved when applying TAM criteria, White's assessment and Dargan's criteria. Conclusion. A hand-based splint with an EAM regimen is a viable treatment option for zone T II EPL surgical repairs instead of a long forearm-based splint. Further research is warranted with a larger sample and using a control group.

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Functional Anatomy of the Thumb Sagittal Band

Cited by 16 publications

References 8 publications

Can Physical Examination Create a Stener Lesion?

Can Physical Examination Create a Stener Lesion?

Ulnar Subluxation of a Ruptured EPL Tendon at the Metacarpophalangeal Joint: Case Report

Retrospective review of hand-based splinting for zone II extensor pollicis longus tendon repairs using an early active motion rehabilitation regimen

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