Article

The purpose of this study was to clarify the definition,
classification and treatment of the disorder known as the locked
metacarpophalangeal (MCP) joint of long fingers, through the analysis of 15 cases
and a literature review. METHODS: We carried out a retrospective
study of 15 patients with locked MCP joint of long fingers, all treated between
1997 and 2007. All patients underwent some imaging investigations including
lateral, anteroposterior and Brewerton X-ray examinations.
All these patients had
been treated by surgery, which allowed us to describe the concerned lesions.
RESULTS: The patients were 47 years old on average, 70% of the locks involved the
index and the middle finger. Twelve fingers were locked in flexion. In nine of
these cases, the cause was a blocking due to a clinging of the radial or ulnar
accessory collateral ligament that overlapped a prominent metacarpal condyle or
an osteophyte of the metacarpal head. Three fingers were locked in extension due
to an imprisonment of a strap of the palmar plate. One patient was lost to
follow-up. The remaining 14 patients had an average follow-up of 12.6 months. All
recovered normal mobility without any recurrence. CONCLUSION: This study and the literature review show that there are in fact two clinical presentations
depending on the etiologies.
We suggest a modification of both Posner's
definition and Harvey's classification; a new classification should focus on the
causes depending on the clinical presentation of the locking, so as to improve
the correlation between clinical presentation, etiology and treatment.
CI - Copyright (c) 2011 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS