The Pastern Joint

This, the proximal interphalangeal articulation (Articulatio phalangis secundæ), is a ginglymus formed by the junction of the distal end of the first phalanx and the proximal end of the second phalanx.

The articular surfaces are: (1) On the first phalanx, two slightly unequal convex areas with an intermediate shallow groove; (2) on the second phalanx, a corresponding surface, completed behind by a plate of fibro-cartilage.

The joint capsule is close fitting in front and laterally, where it blends with the extensor tendon and the lateral ligaments respectively. Behind it pouches upward a little and is reinforced by the straight sesamoidean ligament and the branches of the superficial flexor tendon.

There are two lateral and four volar ligaments.

The lateral ligaments, internal and external (Ligamentum collaterale radiale, ulnare) are very short and strong bands which are attached above on the eminence and depression on each side of the distal end of the first phalanx, and below on the eminence on either side of the proximal end of the second phalanx. The direction of the ligaments is about vertical and, therefore, does not correspond to the digital axis.

The volar or posterior ligaments consist of central and lateral pairs of bands which are attached below to the posterior margin of the proximal end of the second phalanx and its complementary fibro-cartilage. The lateral pair is attached above to the middle of the borders of the first phalanx, the central pair lower down and on the margin of the triangular rough area.

These ligaments are very commonly thickened as a result of chronic inflammation, and then are not well defined. The central ones blend below with the branches of the superficial flexor tendon and with the straight sesamoidean ligament.

Movements.—These are very limited, and consist of flexion and extension. The axis of motion passes transversely through the distal end of the first phalanx. In the standing position the joint is extended. A small amount of volar flexion is possible, and in this position slight lateral flexion and rotation can be produced by manipulation. Dorsal flexion is prevented by the lateral, volar, and straight sesamoidean ligaments.