Surgery: Current Research

ISSN - 2161-1076

Redefining landsmeer ligament: The anatomical and histological study in a High Volume Hand Center, India

Joint Event on International Conference on Plastic & Cosmetic Surgery & International Conference & Expo on Dermatopathology & Skin Care

August 31-September 01, 2018 | Toronto, Canada

Badamutlang Dympep, TM Balakrishnan and J Jaganmohan

Madras Medical College and Rajiv Gandhi Government General Hospital, India

Scientific Tracks Abstracts: Surgery Curr Res

Abstract :

Background: The Oblique Retinacular and Transverse Retinacular ligaments defined by Landsmeer play a significant role in synchronizing the movements of the two distal phalanges of the fingers. However, the anatomy, function, presence and clinical applications of these two ligaments remain obscured till date. Methodology: Anatomical dissection was conducted on 100 cadaveric fingers in 42 cadavers (28 fresh specimens and remaining preserved specimen) under loupe magnification. The whole dorsal digital expansion with attached fibrous flexor sheath was dissected and the specimen was examined. The dimension, course, attachment, and configuration were noted in each specimen. The statistical mean was obtained for thickness, using a caliper at the level of Mid Proximal phalanx, Volar to Proximal Inter-Phalangeal (PIP) joint and Dorsal to Distal Inter-Phalangeal (DIP) joint. Results: The Oblique Retinacular ligament is deep to the Transverse Retinacular ligament. It has got a check rein effect at PIP joint, such a way that extension of PIP joint causes extension of DIP joint. It criss-crosses volar to the A3 pulley of fibrous flexor sheath and forms a good hammock for the PIP joint. This criss-crossing is in contrast to the classical finding of Landsmeer. This article also describes the variation in configuration of Landsmeer ligament among various fingers. It is never absent as reported by several studies. Conclusion: Our study wipes out the controversy that ???ORL is absent in 20% of cases in little finger???. It is present in all little fingers dissected. Contrary to the classical description of Landsmeer, which say ???No criss-crossing???, we found out that there is criss-cross in all fingers volar to A3 pulley and deep to Transverse Retinacular Ligament. And finally, Transverse Retinacular ligament is also present in all fingers.

Biography :

Badamutlang Dympep is a Ist year Resident at the Department of Plastic Surgery. She hails from the remote North-Eastern part of India where there is limited medical accessibility. Under the training of Professor J Jaganmohan and the faculty of MMC, Chennai, she hopes to bring world-class health care to the people in the remote areas, especially in Plastic and reconstructive surgery. Newer and improved methods of reconstructive surgery are conceived out of the vast experience in Plastic Surgery by the faculty in MMC. Through this conference, she will share their research work.