Anatomy of the Palmar Plates: Comparative Morphology and Motion Characteristics
The metacarpophalangeal (MCP) joints and the proximal interphalangeal (PIP) joints have different tolerances for immobilization in a flexed position. Clinically the MCP joints usually tolerate immobilization in flexion with less loss of motion than the PIP joints (with joint contracture probably related to soft tissue stiffness involving the palmar plates, collateral ligaments, and joint capsule). The palmar plates and associated check-rein ligaments have been implicated in the formation of contracture of the PIP joint.13,14 Although the anatomy of the PIP joint palmar plates has been studied,1,4,9,13 little data is available concerning the anatomy of the MCP joint palmar plates and the anatomical differences between the palmar plates of these two joints. Watson14 has hypothesized that certain differences in the anatomy and motion characteristics of the palmar plates of these joints explain their different degrees of tolerance to immobilization in flexion. The purpose of this study was to evaluate this hypothesis by examining in greater detail both anatomic differences between these palmar plates and differences in motion characteristics.
KeywordsMotion Characteristic Initial Length Joint Contracture Proximal Phalanx Loose Connective Tissue
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- 1.W.H. Bowers, J.W. Wolf, J.L. Nehil, and S. Bittinger, The proximal interphalangeal joint volar plate: an anatomical and biomechanical study, J. Hand Surg. 5:79 (1980).Google Scholar
- 2.B.L. Chandrarajan, F.T. Chaykowski, W.J. Forrest, J.T. Bryant, V.P. Wyss, and T.D.V. Cooke, Volar plate insertions of the interosseous muscles of the hand, J. Hand Surg. 13A:309 (1988).Google Scholar
- 4.P. Gad, The anatomy of the volar part of the capsules of the higher joints, J. Bone Joint Surg. 46B:362 (1967).Google Scholar
- 5.D.P. Green, General principles, (In operative hand surgery, 2nd. ed., Green D.P. ed.) Churchill Livingstone, New York, 1 (1988).Google Scholar
- 6.R.S. Idler, R.T. Manktelow, G. Lucas, W.H. Sietz, D.C. Bush, M.P. Rosenwasser, F.M. Watson, and M.D. Putman, (Hand Surgery Manuals Committee, American Society for Surgery of the Hand), The hand: primary care of common hand problems, 3rd edition, Churchill Livingstone, New York, 37 (1990).Google Scholar
- 7.M.A.E. Keenan, R.A. Abrams, D.E. Garland, and R.L. Waters, Results of fractional lengthening of the finger flexor in adults with upper extremity spasticity, J. Hand Surg. 12:575 (1987).Google Scholar
- 8.M.A.E. Keenan, E.P. Todderud, R. Handerson, and M.J. Botte, Management of intrinsic spasticity in the hand with phenol injection or neurectomy of the motor branch of the ulnar nerve, J. Hand Surg. 12:734 (1987).Google Scholar
- 9.K. Kuczynski, The proximal interphalangeal joint: anatomy and causes of stiffness in the fingers, J. Bone Joint Surg. 50B:656 (1968).Google Scholar
- 10.J.D. Lubahn, G.D. Lister, and T. Wolfe, Fasciectomy and Dupuytren’s disease: a comparison between the open-palm technique and wound closure, J. Hand Surg. 9A:53 (1984).Google Scholar
- 12.R.J. Smith, Intrinsic muscles of the fingers: function, dysfunction, and surgical reconstruction, AAOS Instructional Course Lectures, C.V. Mosby, St. Louis, Mo. 24:200 (1975).Google Scholar
- 13.K.H. Watson, T.R. Light, and T.R. Johnson, Check-rein resection for flexion contracture of the middle joint, J. Hand Surg. 4:67 (1979).Google Scholar
- 14.K.H. Watson, and S.H. Turkellaub, Stiff joints, in: Green DP, ed. Operative hand Surgery, New York, Churchill Livingstone, 537 (1988).Google Scholar