The physiological variations in the range of movements are thus to be
explained by variations in the relative length of the anterior fibres
of the lateral ligaments. The ideal constitution of a joint depends
upon the existence of a certain ratio between the growth of bone and
that of ligament. Should the ligaments grow in excess, their redundant
length will permit great super-extension, and may even cease to check
the movement; but if the bone grow relatively faster than the ligaments,
the anterior portion of the latter will the sooner become tense during
extension, and where this disproportion is exceptionally great the
motion may be checked before it attains physiological completeness, the
result being a “hammer finger.” Irregularities of development are most
likely to occur in those joints which, for one or other reason, have the
least functional activity. In the hand the little finger is much less
powerful than its fellows; and in association with this it may often be
noticed that the fourth tendon of the flexor sublimis is reduced to a
mere thread; in the foot the same thing is observed in the corresponding
digit, but in a more marked degree, and it is the degenerate little toe
which is most liable to the “hammer deformity.”
We may then define hammer finger as the result of a developmental
irregularity of the first or second inter-phalangeal joint (rarely of
the metacarpo-phalangeal joint) by which the anterior fibres of the
lateral ligaments become prematurely tense during extension, and so check
that movement before it attains its normal physiological limit. It is
precisely analogous to hammer toe; but it is of less frequency than the
latter affection, because while civilisation sedulously cultivates the
freedom and precision of action in the fingers, it devises foot-coverings
to repress the natural play of the toes. The tendency to the deformity
may be transmitted by descent through an indefinite number of generations.
_Diagnosis._—Spurious hammer finger, like false hammer toe, may occur
from—(1) articular lesions due to rheumatism, rheumatoid arthritis,
gout, tuberculosis, and inflammations of traumatic origin; or (2) from
interference with the muscular functions by paralysis of the extensors or
by spastic contraction of the flexors. In the first group the joint will
be found in a more or less complete state of ankylosis, movements in all
directions being impeded. In the second group the articulation, although
contracted, is freely mobile under passive force, unless, as in some
congenital paralyses, irregularities of development in the articulations
be superadded.
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