Topic: Sagittal Band Ruptures

Greetings colleagues,

Welcome to the Hands-On The East Bay Newsletter, which summarizes key topics in hand surgery for providers on the front lines. I'm Dr. Jesse Dashe, an orthopedic hand surgeon at the East Bay Hand Medical Center.

Sagittal Band Ruptures: A Complex Injury in Hand Trauma

Sagittal band ruptures represent a challenging yet fascinating aspect of hand injuries, often presenting in the context of direct trauma or chronic strain.

Question:
What exactly are Sagittal Band Ruptures?

Answer:
Sagittal band ruptures involve the tearing of the sagittal bands, which are crucial structures encircling the metacarpophalangeal (MCP) joints. These bands stabilize the extensor tendons over the dorsal aspect of the MCP joints. Injury to these bands can lead to extensor tendon instability, commonly resulting in a characteristic 'snapping' phenomenon.

Clinical Presentation and Diagnosis

Patients with sagittal band ruptures often present with pain, swelling, and a noticeable snapping or catching sensation during finger movement.

Question:
How are Sagittal Band Ruptures diagnosed?

Answer:
The diagnosis is primarily clinical, with a focus on the history of trauma or repetitive strain, physical examination findings, and specific maneuvers to elicit the snapping sensation. Imaging, such as MRI, can be helpful in confirming the diagnosis and assessing the extent of the injury. This can be mistaken for a trigger finger. The most common digit involved is the middle finger.

Management Strategies: A Balance of Conservative and Surgical Approaches

The treatment of sagittal band ruptures varies based on the severity of the injury and the functional demands of the patient.

Question:
What are the treatment options for Sagittal Band Ruptures?

Answer:
Mild cases may respond well to conservative management, including splinting and occupational therapy. However, surgical intervention is often required for complete ruptures or cases with persistent symptoms despite conservative measures. Surgical repair aims to restore the stability of the extensor tendon at the MCP joint.

In Closing:

Sagittal band ruptures, while not as common as other hand injuries, pose unique challenges in diagnosis and management. Understanding the nuances of this injury is crucial for ensuring optimal functional outcomes for our patients.

Please feel free to reach out for discussions, patient referrals, or suggestions for future topics. Together, we continue to advance our knowledge and skills in orthopedic hand surgery.

Sincerely,

Please feel free to reach out if you have any questions or would like to refer any patients. You can refer patients at handreferral.com or by using this link:

If you need to reach me directly, please respond to this email or email me at [email protected].

Please contact me so I can come by your facility to meet face-to-face and/or give presentations, splinting sessions, etc.

Lastly, let me know if you have any other hand topics you would like covered in the future!

Sincerely,

Jesse Dashe, MD