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Purpose: When reconstructing collateral ligaments of the proximal interphalangeal joint (PIP), precise location is critical to ensure anatomical placement. Previous studies describing the anatomic location of these ligaments have been controversial. We sought to analyze the footprint of the ligaments and describe them in reference to anatomic landmarks.

Methods: 16 cadaveric fingers from four frozen cadaver hands were dissected under loupe magnification. Measurements included total width of the phalanx, footprints of the origin and insertion.

Results: The average width of the proximal phalanx was 6.125mm (5-8mm) and the footprint of the PIP collateral ligament averaged 2.625mm (2-4mm) from the dorsal aspect of the phalanx and was, on average, 3.5mm (3-4mm) proximal from the endplate. The width of the middle phalanx averaged 6.375mm (5-8mm) and the insertion of the PIP collateral ligament averaged 3.75mm (3-5mm) from the volar aspect of the phalanx and was, on average, 1.125mm (1-2mm) distal to the proximal aspect of the phalanx.

Conclusion: The anatomy of the PIP collateral ligaments appears to run in a dorsoproximal to volar distal direction. The origin appears to be slightly dorsal and proximal to the condylar recess. This anatomical consideration may be helpful in PIP collateral ligament release and ligament reconstruction.