What happens during surgery for sesamoid impingement of the little finger?
On the channel as “SESAMOID IMPINGEMENT”
In this video Dr. Knight narrates surgery for sesamoid impingement of the little finger, at the fifth metacarpophalangeal joint. A small bone catches on the head of the fifth metacarpal and makes the finger snap. He shows the catching before surgery, the sesamoid being freed from its soft tissue attachments with the nerves and vessels protected, and the worn cartilage found on both hands.
This is a transcript of a recorded talk from 2018. Any figures mentioned are from the recording and are not statements about current results or the practice.
Read the transcript 169 words
The transcript below is what Dr. Knight says in the video. We corrected the anatomy, drug and device names the automatic captions got wrong and added the punctuation and paragraph breaks. No words were changed, added or taken out. The uncorrected machine transcript is kept on file.
Transcript
Sesamoid impingement. This involved a patient with bilateral snapping little fingers. This shows preoperatively the snapping of the fifth MCP joint. On cine radiography, you can see the sesamoid catching on the volar aspect of the fifth metacarpal head, going from flexion into extension.
Intraoperatively, just before surgery, again demonstrating the catching. Again, this was bilateral. Sesamoidectomy underway. It shows the flexor tendons in the 12 o'clock position, working beneath these, removing the sesamoid overlying the fifth metacarpal head. See the chondromalacia on the inferior surface of the sesamoid. See the metacarpophalangeal joint beneath.
Releasing all soft tissue attachments to the sesamoid while protecting the neurovascular structures just ulnar to this. Now you can see the chondromalacia. Now comparing both sides, both hands, severe chondromalacia of the articular surface of the sesamoid bilaterally.
Wound has been sutured, patient is awakened and has to flex and extend the digit with marked improvement in the preoperative snapping. Post clinical motion, again full range of motion, no further discomfort, no significant snapping.
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