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The retinacular ligaments of the digital extensor expansion revisited : An anatomical and biomechanical study

Borgström, Tomas LU ; Dahlin, Lars B. LU orcid and Tranum-Jensen, Jørgen (2023) In Clinical Anatomy
Abstract

Our aim was to clarify the anatomy and function of the retinacular ligaments. Forty-eight fingers were dissected and the thickness of the oblique retinacular ligament (ORL) was graded. In four fingers, the motion in the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints was subjected to an in-depth analysis before and after sectioning of either the lateral bands (LB) or the ORLs. The function of the ORLs in restricting flexion of the DIP joint with full extension of the PIP joint was measured in 10 fingers. An ORL could be identified on both sides in all 48 fingers. The distribution of the insertion on the proximal phalanx was 7/96 (7%) in the distal third, 70/96 (73%) in the middle third and 19/96 (20%) in the... (More)

Our aim was to clarify the anatomy and function of the retinacular ligaments. Forty-eight fingers were dissected and the thickness of the oblique retinacular ligament (ORL) was graded. In four fingers, the motion in the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints was subjected to an in-depth analysis before and after sectioning of either the lateral bands (LB) or the ORLs. The function of the ORLs in restricting flexion of the DIP joint with full extension of the PIP joint was measured in 10 fingers. An ORL could be identified on both sides in all 48 fingers. The distribution of the insertion on the proximal phalanx was 7/96 (7%) in the distal third, 70/96 (73%) in the middle third and 19/96 (20%) in the proximal third. Among the specimens, 29% were graded as having a strong bundle of fibers, 51% as having well-defined and regular fibers and 20% as having thin and sparse fibers. With the PIP joint extended, there was a statistically significant increase in flexion of the DIP joint after the ORL was cut. After the LB was sectioned, the ORL was able to extend the DIP joint with an extension lag of 10–22°. Cutting the ORL did not affect the ability to extend that joint. We conclude that the retinacular ligaments are consistent. Their major role is not connected with finger movement, but to provide stabilizing links between the PIP and DIP joints. They are active in not only specific, uncommon finger positions but also in ordinary use of the fingers.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
anatomy, aponeurosis, apparatus, extensor, finger joints, fingers, hand surgery, Landsmeer, ligaments, movement, oblique, retinacular, tendons, transverse
in
Clinical Anatomy
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:37747299
  • scopus:85172812460
ISSN
0897-3806
DOI
10.1002/ca.24114
language
English
LU publication?
yes
id
0ffdd226-c402-453e-a3e1-9ed9bc420545
date added to LUP
2023-12-20 14:57:56
date last changed
2024-04-19 00:29:34
@article{0ffdd226-c402-453e-a3e1-9ed9bc420545,
  abstract     = {{<p>Our aim was to clarify the anatomy and function of the retinacular ligaments. Forty-eight fingers were dissected and the thickness of the oblique retinacular ligament (ORL) was graded. In four fingers, the motion in the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints was subjected to an in-depth analysis before and after sectioning of either the lateral bands (LB) or the ORLs. The function of the ORLs in restricting flexion of the DIP joint with full extension of the PIP joint was measured in 10 fingers. An ORL could be identified on both sides in all 48 fingers. The distribution of the insertion on the proximal phalanx was 7/96 (7%) in the distal third, 70/96 (73%) in the middle third and 19/96 (20%) in the proximal third. Among the specimens, 29% were graded as having a strong bundle of fibers, 51% as having well-defined and regular fibers and 20% as having thin and sparse fibers. With the PIP joint extended, there was a statistically significant increase in flexion of the DIP joint after the ORL was cut. After the LB was sectioned, the ORL was able to extend the DIP joint with an extension lag of 10–22°. Cutting the ORL did not affect the ability to extend that joint. We conclude that the retinacular ligaments are consistent. Their major role is not connected with finger movement, but to provide stabilizing links between the PIP and DIP joints. They are active in not only specific, uncommon finger positions but also in ordinary use of the fingers.</p>}},
  author       = {{Borgström, Tomas and Dahlin, Lars B. and Tranum-Jensen, Jørgen}},
  issn         = {{0897-3806}},
  keywords     = {{anatomy; aponeurosis; apparatus; extensor; finger joints; fingers; hand surgery; Landsmeer; ligaments; movement; oblique; retinacular; tendons; transverse}},
  language     = {{eng}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical Anatomy}},
  title        = {{The retinacular ligaments of the digital extensor expansion revisited : An anatomical and biomechanical study}},
  url          = {{http://dx.doi.org/10.1002/ca.24114}},
  doi          = {{10.1002/ca.24114}},
  year         = {{2023}},
}