The oblique retinacular ligament (Landsmeer ligament) runs obliquely in the finger from the volar base of the proximal phalanx across the lateral surface of the PIP joint to insert on the extensor mechanism at the DIP joint level. Its oblique path coordinates DIP and PIP joint motion: when the PIP extends, the ligament tightens and passively extends the DIP; when the PIP flexes, the ligament slackens allowing independent DIP flexion.
Passively links PIP and DIP joint motion, facilitating simultaneous extension of both joints during finger straightening. Its tightness in scarring causes inability to flex the DIP while the PIP is straight (positive ORL test).
The oblique retinacular ligament becomes contracted (tethered) in boutonniere deformity when the central slip rupture allows PIP flexion and DIP hyperextension chronically, and in swan-neck deformity. The ORL tightness test (inability to flex the DIP passively when the PIP is in full extension) distinguishes intrinsic tightness from ORL tightness in complex finger deformities. In reconstruction of swan-neck and boutonniere, the ORL is addressed surgically by tenotomy or advancement.
Chronic PIP flexion from central slip rupture allows the oblique retinacular ligament to contract, fixing DIP hyperextension and resisting passive DIP flexion even when the PIP is corrected; ORL release is required during boutonniere reconstruction to restore normal DIP excursion.
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