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A complete radial collateral ligament avulsion of the small finger metacarpophalangeal joint with displacement through the radial sagittal band.

ABSTRACT: A displaced complete radial collateral ligament avulsion with associated injury to the sagittal band of the metacarpophalangeal joint of the small finger, if left untreated, may result in chronic pain, instability, weakness, and deformity. A case of a displaced radial collateral ligament that ruptured through the radial sagittal band of the small finger, with resultant injury to the extensor mechanism, is described and discussed with a review of the literature. Proper identification of this injury by physical exam and imaging studies along with surgical repair is associated with good outcome.

SUBMITTER: Dennison DG

PROVIDER: S-EPMC2525884 | biostudies-other | 2008 Sep

REPOSITORIES: biostudies-other

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Project description:BackgroundEvidence supports the use of hand-based metacarpophalangeal joint (MCPJ) blocking splints as an intervention for trigger finger (TF). In practice, finger-based relative motion (RM) splints are also implemented without evidence.PurposeThis randomized comparative trial (RCT) aims to evaluate implementation of MCPJ blocking and RM splints for effectiveness, function, occupational performance and wearability after 6 weeks of TF management.Methods and analysisPriori analysis determined 36 individuals were needed for random assignment to the RM or MCPJ blocking splint groups. Individuals must be aged ≥21 years, and diagnosed with TF involving ≥1 finger. For blinding purposes, the primary author screens for eligibility, fabricates the splints and educates. Therapist A administers the primary outcome measures Week-1 and Week-6-stage of stenosing tenosynovitis and secondary outcome measures- number of triggering events in 10 active fists, visual analog scales (VAS) for pain, splint comfort and satisfaction, Disabilities of the Arm, Shoulder and Hand, and Canadian Occupational Performance Measure. Therapist B in Week-3 instructs participants in deep tissue massage and administers splint wearability VASs. The RM pencil test is used to determine the affected finger(s) MCPJ splint position i.e., more extension or flexion based on participant response. The MCPJ blocking splint holds the MCPJ in a neutral position. Analysis involves a mixed-effects ANOVA to compare Week-1 and Week-6 primary and secondary outcomes.ResultsRecruitment and data collection are ongoing.DiscussionBiomechanically RM splints control tendon excursion and reduce passive tendon tension while allowing unencumbered finger motion and hand function. Hence clinicians use RM splints as an intervention for TF, despite the lack of implementation evidence. This RCT implements a function-focused as well as patient-centered approach with partial blinding of assessors and participants.ConclusionWe anticipate that this study will provide evidence for the implementation of RM splints to manage adults with TF.Trial registrationClinical trial registration This trial is registered with ClinicalTrials.gov (NCT05763017).

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A complete radial collateral ligament avulsion of the small finger metacarpophalangeal joint with displacement through the radial sagittal band.

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