The Association Between the Extent of Sagittal Band Disruption and Extensor Tendon Subluxation in Different Flexion Angles: A Cadaveric Study

Makaleler > Tam Makale · 2026

Yazarlar: Omar al jasim, Arman Vahabi, Ali Engin DAŞTAN, Hüseyin GÜNAY

JOURNAL OF HAND SURGERY-AMERICAN VOLUME, SCI İndekslerine Giren Dergi, Uluslararası, Scopus, 2026, cilt 2, ss 195-202

DOI: 10.1016/j.jhsa.2025.04.026

Özet

<p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Abstract</strong></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Purpose:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">We&nbsp;aimed&nbsp;to&nbsp;quantitatively&nbsp;assess&nbsp;the&nbsp;relationship&nbsp;between&nbsp;the&nbsp;extent&nbsp;of&nbsp;sagittal&nbsp;band&nbsp;damage&nbsp;and&nbsp;tendon&nbsp;stability&nbsp;across&nbsp;different&nbsp;fingers&nbsp;and&nbsp;positions&nbsp;while&nbsp;also&nbsp;examining&nbsp;the&nbsp;effects&nbsp;of&nbsp;proximal&nbsp;versus&nbsp;distal&nbsp;damage.</span></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Methods:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">This&nbsp;was&nbsp;a&nbsp;cadaveric&nbsp;study&nbsp;conducted&nbsp;on&nbsp;the&nbsp;index,&nbsp;middle,&nbsp;ring,&nbsp;and&nbsp;little&nbsp;fingers&nbsp;of&nbsp;nine&nbsp;cadavers.&nbsp;Damage&nbsp;was&nbsp;induced&nbsp;through&nbsp;stepwise&nbsp;sectioning&nbsp;either&nbsp;from&nbsp;the&nbsp;proximal&nbsp;or&nbsp;distal&nbsp;end.&nbsp;Sectioning&nbsp;was&nbsp;performed&nbsp;in&nbsp;increments&nbsp;of&nbsp;10%,&nbsp;25%,&nbsp;50%,&nbsp;75%,&nbsp;90%,&nbsp;and&nbsp;100%.&nbsp;Photographs&nbsp;were&nbsp;taken&nbsp;to&nbsp;measure&nbsp;subluxation&nbsp;at&nbsp;metacarpophalangeal&nbsp;joint&nbsp;positions&nbsp;of&nbsp;0°,&nbsp;45°&nbsp;flexion,&nbsp;and&nbsp;90°&nbsp;flexion.&nbsp;Data&nbsp;from&nbsp;the&nbsp;index,&nbsp;middle,&nbsp;and&nbsp;ring&nbsp;fingers&nbsp;were&nbsp;pooled,&nbsp;whereas&nbsp;data&nbsp;on&nbsp;the&nbsp;little&nbsp;finger&nbsp;were&nbsp;analyzed&nbsp;separately.</span></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Results:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Subluxation&nbsp;was&nbsp;greater&nbsp;with&nbsp;proximal&nbsp;to&nbsp;distal&nbsp;sectioning&nbsp;at&nbsp;25%,&nbsp;75%,&nbsp;and&nbsp;90%&nbsp;damage&nbsp;thresholds.&nbsp;Ten&nbsp;percent&nbsp;sectioning&nbsp;resulted&nbsp;in&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;5.1%&nbsp;(95%&nbsp;confidence&nbsp;interval&nbsp;[CI],&nbsp;2.5-7.7);&nbsp;25%&nbsp;sectioning&nbsp;led&nbsp;to&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;13.6%&nbsp;(95%&nbsp;CI,&nbsp;7.9-19.3);&nbsp;50%&nbsp;sectioning&nbsp;resulted&nbsp;in&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;15.3%&nbsp;(95%&nbsp;CI,&nbsp;9.2-21.3);&nbsp;75%&nbsp;sectioning&nbsp;resulted&nbsp;in&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;18.1%&nbsp;(95%&nbsp;CI,&nbsp;12.2-23.9);&nbsp;90%&nbsp;sectioning&nbsp;led&nbsp;to&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;24.1%&nbsp;(95%&nbsp;CI,&nbsp;17.5-30.7);&nbsp;and&nbsp;100%&nbsp;sectioning&nbsp;resulted&nbsp;in&nbsp;a&nbsp;mean&nbsp;subluxation&nbsp;of&nbsp;41.6%&nbsp;(95%&nbsp;CI,&nbsp;33.7-49.5).&nbsp;Regarding&nbsp;the&nbsp;little&nbsp;finger,&nbsp;complete&nbsp;dislocation&nbsp;occurred&nbsp;in&nbsp;only&nbsp;one&nbsp;of&nbsp;the&nbsp;nine&nbsp;fingers.</span></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Conclusions:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Even&nbsp;minimal&nbsp;sagittal&nbsp;band&nbsp;damage&nbsp;results&nbsp;in&nbsp;measurable&nbsp;subluxation,&nbsp;but&nbsp;the&nbsp;presence&nbsp;of&nbsp;even&nbsp;10%&nbsp;intact&nbsp;fibers&nbsp;confers&nbsp;some&nbsp;stability&nbsp;against&nbsp;subluxation.&nbsp;As&nbsp;the&nbsp;extent&nbsp;of&nbsp;sagittal&nbsp;band&nbsp;disruption&nbsp;increases,&nbsp;the&nbsp;extensor&nbsp;tendon&nbsp;progressively&nbsp;deviates&nbsp;from&nbsp;its&nbsp;native&nbsp;position.&nbsp;Damage&nbsp;to&nbsp;the&nbsp;proximal&nbsp;fibers&nbsp;has&nbsp;a&nbsp;more&nbsp;detrimental&nbsp;impact&nbsp;on&nbsp;tendon&nbsp;stability.</span></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Clinical&nbsp;relevance:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">The&nbsp;relationship&nbsp;between&nbsp;sagittal&nbsp;band&nbsp;integrity&nbsp;and&nbsp;tendon&nbsp;stability&nbsp;extends&nbsp;beyond&nbsp;a&nbsp;simple&nbsp;dislocation&nbsp;threshold.&nbsp;Both&nbsp;the&nbsp;extent&nbsp;of&nbsp;damage&nbsp;and&nbsp;location&nbsp;of&nbsp;the&nbsp;disrupted&nbsp;fibers&nbsp;are&nbsp;associated&nbsp;with&nbsp;the&nbsp;degree&nbsp;of&nbsp;subluxation.</span></p><p><strong style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Keywords:&nbsp;</strong><span style="background-color: rgb(255, 255, 255); color: rgb(33, 33, 33);">Experimental;&nbsp;extensor&nbsp;hood;&nbsp;extensor&nbsp;tendon;&nbsp;sagittal&nbsp;band&nbsp;rupture;&nbsp;sagittal&nbsp;band&nbsp;sectioning.</span></p><p></p>

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