- Transverse Retinacular Ligaments:
- anatomy:
- origin: edge of flexor tendon sheath at PIP;
- insetion: lateral edges of conjoined
lateral bands
- function:
- prevents excessive dorsal shift of the lateral bands when the PIP extends;
- in flexion, they pull the
lateral bands volarly over the PIP joint;
- pathology:
- attenuation of
transverse retinacular ligament by laceration, rupture,
synovitis, ect., leads to excessive dorsal position of
lateral bands &
secondary "
Swan Neck Deformity;"
- tightening of transverse retinacular ligaments along with attenuation or
disruption of a triangular ligament leads to a positioning of the lateral
bands volar to axis of PIP joint resulting in a
boutonnere deformity;
- Oblique Retinacular Ligament:
- cord that runs from flexor tendon sheath at the proximal phalanx to the
terminal extensor tendon;
-
anatomy - oblique retinacular ligament
- origin
- volar lateral crest of proximal phalanx;
- course
- volar to axis of PIP joint
- insertion - lateral terminal extensor tendon;
-
function:
- functional importance questioned;
- links motion of DIP and PIP joints;
- when PIP joint is flexed, ligament relaxes allowing DIP flexion;
- PIP extension tightens ligament facilitating DIP extension, thus
theoretically linking motion of PIP and DIP joints;
-
pathophysiology:
- may be involved with Dupuytren's contracture causing flexion of
PIP joint and extension of the DIP joint;
- may be reconstructed, (SORL reconstruction) to facilitate DIP extension
and prevent PIP hyperextension;
- contracture of oblique retinacular ligaments along w/ volar displacement
of
lateral bands cause boutonniere injury;
-
test for ORL tightness:
- extend the PIP joint (which tightens the ligament) and then note resistance
to passive DIP flexion (relative to when the PIP is flexed)
Anatomy of the oblique retinacular ligament of the index finger.
The Spiral Oblique Retinacular Ligament.
JS Thompson MD, JW Littler MD, and J Upton MD.
J. Hand Surg. Vol 3, No 5, p 482, Sep 1978.
A systemic study of the oblique retinacular ligament of the human finger: its structure and function.
MM Shrewsbury and RK Johnson.
J. Hand Surg. Vol 2. p 194. 1977.
