Injuries to the Digital Joints

Conservative and Postoperative Treatment

Metacarpophalangeal collateral ligament injury (digits II–V)

Collateral ligaments of the MP joint support the joint, especially during grip and pinch. Taut in flexion and lax in extension, these ligaments are most frequently injured as a result of hyperextension or extreme lateral force. The radial ligament is more vulnerable than the ulnar collateral ligaments. Partial tears are usually treated conservatively, whereas complete tears are corrected surgically. Conservative management and postoperative management are nearly similar and have been consolidated here.

The PIP collateral ligament consists of the proper collateral ligament and the accessory collateral ligament. The primary stabilizer, the PCL, is taut in flexion and lax in extension, whereas the ACL is taut in extension and lax in flexion. Grade I sprains are stable through AROM and PROM. Stress testing may be painful, but stable. Grade II indicates a complete tear of at least one collateral ligament. It is stable through AROM and demonstrates less than 20 degrees of angulation. Grade III injuries include at least one collateral ligament and some aspect of the volar or dorsal structures. It is unstable in both AROM and PROM and usually requires surgical correction.