Reconstruction of chronic thumb metacarpophalangeal radial collateral ligament injuries with free tendon grafts
Birkan Kibar, Fahri Erdi Malkoç
Department of Orthopedics and Traumatology, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
Keywords: Chronic, graft, metacarpophalangeal joint, radial collateral ligament, tendon, thumb, traumatic
Objectives: This study aims to review our reconstruction method to treat chronic grade 3 thumb metacarpophalangeal (MP) joint radial collateral ligament (RCL) tears using free tendon grafts.
Patients and methods: Thirteen male patients (mean age 41 years; range, 20 to 67 years) who received a free tendon graft to treat chronic grade 3 thumb MP joint RCL injury between May 2016 and July 2018 were evaluated prospectively. Patients with incomplete bone maturation (n=1), those who had additional injuries in the same extremity (n=1), and those who had previously undergone surgery on the same extremity (n=1) were excluded. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used for functional evaluation and the visual analog scale (VAS) was also used for pain evaluation.
Results: The decrease in DASH (p=0.008) and VAS (p=0.03) scores and the increase in grip (p=0.031) and pinch strength (p=0.006) between the preoperative and final follow-up values were statistically significant. No ulnar deviation was observed in X-rays at the final examination, nor was MP joint radial instability observed under ulnar stress during clinical examinations. In two patients, 1 and 1.5 mm palmar subluxation was observed at final examination. The other 11 patients had no palmar subluxation at final examination.
Conclusion: Although ours is a more complicated method compared to other reconstruction approaches, we think that it is a suitable alternative for achieving joint stability and good functional results.
Citation: Kibar B, Malkoç FE. Reconstruction of chronic thumb metacarpophalangeal radial collateral ligament injuries with free tendon grafts. Jt Dis Relat Surg 2020;31(1):62-67.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.