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In the light of a physiopathological study of severe medial strain of the metacarpophalangeal joint of the thumb in 20 cadaver hands, the authors propose a correlation between anatomical and clinical findings and a classification derived from it: Stage I: rupture of one fascicle of the collateral ligament. Passive valgus mobility of less than 15 degrees. The ruptured ends of the ligament remain in contact. Stage II: rupture of both fascicles of the ligament. Passive valgus and supination mobility of the metacarpophalangeal joint of 20 to 40 degrees. Interposition of the dorsal digital expansion between the ruptured ends of the ligament. Abnormal movements can be corrected by applying tension to the dorsal digital expansion. Stage III: rupture of both fascicles of the collateral ligament and the dorsal digital expansion. Tension from the thenar muscles causes abnormal movement and produces a fixed flexion of the metacarpophalangeal joint with hyperextension of the interphalangeal joint (Z-shaped thumb). From this the authors determine the operative indications and suggest a palliative ligamentoplasty to restore the anatomy as much as possible.

The displacement of the proximal and distal fragments of fractures of the carpal scaphoid have been studied in fresh cadavers. In 10 subjects, a comparison has been made between a below-elbow plaster, a moulded plaster gauntlet and an above-elbow plaster. The most satisfactory immobilisation has been obtained with a moulded plaster gauntlet incorporating the proximal phalanx of the thumb and leaving the elbow free.

The authors report a case of traumatic rupture of the tendon of the adductor magnus. It was operated on one month after the injury when it had formed a painful contractile tumour in the perineal region. The tendon was re-attached to the femur. The result was satisfactory. The authors have made a review of the literature.