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The accessory ligament and the proximal margin of the palmar plate are flexible and fold back upon themselves during flexion. The flexor tendon sheaths are firmly attached to the proximal and middle phalanges by annular pulleys A2 and A4, while the A3 pulley and the proximal fibres of the C1 ligament
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The relative length of the digit varies during motion of the IP joints. The length of the palmar aspect decreases during flexion while the dorsal aspect increases by about 24 mm. The useful range of motion of the PIP joint is 30–70°, increasing from the index finger to the little finger. During
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At the level of the PIP joint the extensor mechanism splits into three bands. The central slip attaches to the dorsal tubercle of the middle phalanx near the PIP joint. The pair of lateral bands, to which contribute the extensor tendons, continue past the PIP joint dorsally to the joint axis. These
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ligament, which runs from the palmar border of the lateral band to the flexor sheath at the level of the joint and which prevents dorsal displacement of that lateral band. On the palmar side of the joint axis of motion, lies the oblique retinacular ligament which stretches from the flexor sheath
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is thinner and more flexible in its central-proximal part. On both sides it is reinforced by the so-called check rein ligaments. The accessory collateral ligaments (ACL) originate at the proximal phalanx and are inserted distally at the base of the middle phalanx below the collateral ligaments.
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The palmar plate is supported by a ligament on either side of the joint called the collateral ligaments, which prevent deviation of the joint from side to side. The ligaments can partially or fully tear and can avulse with a small fracture fragment when the finger is forced backwards into
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in the dorsal and palmar plates is important in resisting compression forces against the condyles of the proximal phalanx. Together these structures protect the tendons passing in front and behind the joint. These tendons can sustain traction forces thanks to their collagen fibers.
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The palmar plate forms a semi-rigid floor and the collateral ligaments the walls in a mobile box which moves together with the distal part of the joint and provides stability to the joint during its entire range of motion. Because the palmar plate adheres to the
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maximum flexion the base of the middle phalanx is firmly pressed into the retrocondylar recess of the proximal phalanx, which provides maximum stability to the joint. The stability of the PIP joint is dependent of the tendons passing around it.
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The capsule, extensor tendon, and skin are very thin and lax dorsally, allowing for both phalanx bones to flex more than 100° until the base of the middle phalanx makes contact with the condylar notch of the proximal phalanx.
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The PIP joint exhibits great lateral stability. Its transverse diameter is greater than its antero-posterior diameter and its thick collateral ligaments are tight in all positions during flexion, contrary to those in the
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over the proximal phalanx to the terminal extensor tendon. In extension, the oblique ligament prevents passive DIP flexion and PIP hyperextension as it tightens and pulls the terminal extensor tendon proximally.
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attach the sheaths to the mobile volar ligament at the PIP joint. During flexion this arrangement produces a space at the neck of the proximal phalanx which is filled by the folding palmar plate.
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are attached proximally and in the segmentation of the flexor tendon sheath, but the major differences are the smaller dimension and reduced mobility of the distal joint.
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near the distal attachment of the muscle, it also increases the moment of flexor action. In the PIP joint, extension is more limited because of the two so called
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generally spares the distal interphalangeal joints. Therefore, arthritis of the distal interphalangeal joints strongly suggests the presence of
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Anatomically, the proximal and distal interphalangeal joints are very similar. There are some minor differences in how the
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210:"proximal interphalangeal joints" (PIJ or PIP), those between the first (also called proximal) and second (intermediate)
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Flexion is more extensive, about 100°, in the PIP joints and slightly more restricted, about 80°, in the DIP joints.
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216:"distal interphalangeal joints" (DIJ or DIP), those between the second (intermediate) and third (distal) phalanges
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Metacarpophalangeal joint and joints of digit. Palmar aspect. Palmar ligament labelled as volar ligament.
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Interphalangeal ligaments and phalanges. Right hand. Deep dissection. Posterior (dorsal) view.
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Knowledge articles incorporating text from the 20th edition of Gray's
Anatomy (1918)
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There are two sets in each finger (except in the thumb, which has only one joint):
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hyperextension. This is called a "palmar plate, or volar plate injury".
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articulationes interphalangeae manus, articulationes digitorum manus
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ligaments, which attach the palmar plate to the proximal phalanx.
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The only movements permitted in the interphalangeal joints are
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578:"Diagnosis and differential diagnosis of rheumatoid arthritis"
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Extension is limited by the volar and collateral ligaments.
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In contrast, on the palmar side, a thick ligament prevents
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289:. The distal part of the palmar ligament, called the
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Collateral ligament of interphalangeal joints of hand
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860:Glenohumeral (superior, middle, and inferior)
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370:The muscles generating these movements are:
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550:"Rheumatoid Arthritis Signs and Symptoms"
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44:The DIP, PIP and MCP joints of the hand:
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272:three bands are united by a transverse
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677:This article incorporates text in the
626:Brüser, Peter; Gilbert, Alain (1999).
548:Victoria Ruffing, Clifton O. Bingham.
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646:
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27:Hinge joints between finger phalanges
18:Interphalangeal articulations of hand
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535:"Hand Therapy - Volar Plate Injury"
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185:interphalangeal joints of the hand
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1161:Superficial transverse metacarpal
653:Joint stiffness of the upper limb
613:Volar Plate Injury - Hand Therapy
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199:that provide flexion towards the
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988:Interosseous membrane of forearm
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576:PJW Venables, Ravinder N Maini.
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649:"Interphalangeal joint anatomy"
806:Inferior transverse of scapula
651:. In Copeland, Stephen (ed.).
629:Finger bone and joint injuries
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470:Interphalangeal joints of foot
406:acting on the proximal joints
404:flexor digitorum superficialis
337:flexor digitorum superficialis
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1:
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801:Superior transverse scapular
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685:of the 20th edition of
594:Last updated: Jan 22, 2016.
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1156:Deep transverse metacarpal
764:Posterior sternoclavicular
475:Metacarpophalangeal joints
392:flexor digitorum profundus
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759:Anterior sternoclavicular
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522:Brüser & Gilbert 1999
251:metacarpophalangeal joint
236:Joints of the hand, X-ray
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1080:Interosseous intercarpal
655:. Taylor & Francis.
632:. Taylor & Francis.
433:extensor pollicis longus
647:Lluch, Alberto (1997).
1122:Palmar carpometacarpal
1117:Dorsal carpometacarpal
566:Updated: April 4, 2017
555:Johns Hopkins Hospital
427:flexor pollicis longus
315:
245:
237:
167:Anatomical terminology
445:Clinical significance
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256:Further information:
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235:
608:Diagram at depuy.com
450:Rheumatoid arthritis
1171:Metacarpophalangeal
929:Proximal radioulnar
458:psoriatic arthritis
1075:Palmar intercarpal
1070:Dorsal intercarpal
1023:Palmar radiocarpal
1019:Dorsal radiocarpal
865:Transverse humeral
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33:Joints of the hand
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1133:Radial collateral
1041:Radial collateral
1032:Palmar ulnocarpal
1028:Dorsal ulnocarpal
1011:Wrist/radiocarpal
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983:Dorsal radioulnar
978:Palmar radioulnar
970:Distal radioulnar
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901:Radial collateral
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817:Acromioclavicular
784:Acromioclavicular
639:978-1-85317-690-6
524:, pp. 158–60
505:, pp. 259–60
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281:Palmar structures
263:Dorsal structures
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16:(Redirected from
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1138:Ulnar collateral
1037:Ulnar collateral
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102:Human hand bones
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1085:Scapholunate
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842:Glenohumeral
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189:hinge joints
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136:A03.5.11.601
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1228:Ulnar canal
1051:Intercarpal
911:Humeroulnar
792:Syndesmoses
295:chondroitin
274:retinacular
113:Identifiers
1269:Categories
1202:Collateral
1179:Collateral
1094:Pisohamate
589:2017-08-10
561:2017-08-10
503:Lluch 1997
481:References
415:interossei
411:lumbricals
382:Extension
341:check-rein
1056:Midcarpal
826:trapezoid
730:ligaments
376:Location
357:extension
347:Movements
212:phalanges
193:phalanges
87:halangeal
72:halangeal
58:halangeal
947:Quadrate
813:Synovial
742:Shoulder
683:page 333
583:UpToDate
464:See also
396:proximal
387:fingers
379:Flexion
187:are the
64:roximal
1259:Anatomy
961:Forearm
850:Capsule
732:of the
353:flexion
197:fingers
195:of the
108:Details
1280:Joints
1245:Portal
1207:Palmar
1184:Palmar
937:Anular
831:conoid
726:Joints
691:(1918)
659:
636:
422:thumb
400:distal
50:istal
1216:Other
1128:thumb
884:Elbow
681:from
171:[
160:35285
119:Latin
1285:Hand
1002:Hand
728:and
657:ISBN
634:ISBN
431:the
425:the
413:and
398:and
390:the
355:and
318:The
297:and
183:The
148:1839
131:TA98
83:arpo
68:nter
54:nter
734:arm
456:or
155:FMA
143:TA2
79:eta
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77:M
70:P
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48:D
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