Novel figure-of-eight reconstruction with free tendon graft for unrepairable collateral ligament of the thumb metacarpophalangeal joint.

Autor: Baek JH; Department of Orthopedic Surgery, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, 23 Kyunghee-daero, Dongdaemun-gu, Seoul, 02447, Korea. Electronic address: paeton81@naver.com., Lee JH; Department of Orthopedic Surgery, Yeson Hospital, 206 Bucheon-ro, Bucheon-si, Gyeonggi-do, 14555, Korea. Electronic address: ljhos69@naver.com., Ku KH; Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, School of Medicine, Graduate School, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Korea. Electronic address: bestdoctorku@gmail.com.
Jazyk: angličtina
Zdroj: Hand surgery & rehabilitation [Hand Surg Rehabil] 2024 Jun; Vol. 43 (3), pp. 101696. Date of Electronic Publication: 2024 Apr 22.
DOI: 10.1016/j.hansur.2024.101696
Abstrakt: Objectives: This study aimed to report surgical technique and clinical outcomes for a novel figure-of-eight collateral ligament reconstruction technique using palmaris longus autograft for chronic irreparable collateral ligament injury of the thumb metacarpophalangeal joint.
Material and Methods: The Jobe elbow collateral ligament reconstruction method was adapted for thumb metacarpophalangeal joint collateral ligament reconstruction. Sixteen reconstructions (7 ulnar collateral ligament, 9 radial collateral ligament) using palmaris longus autograft were reviewed retrospectively. Surgery was performed at a mean 12 months post-injury. All 16 patients were followed up for more than 1 year. Metacarpophalangeal joint radial and ulnar deviation, metacarpophalangeal and interphalangeal joint range of motion, key pinch and grip strength, Glickel functional grade and QuickDASH score were evaluated.
Results: Preoperative radial or ulnar deviation improved from 19.3° to 5.3° postoperatively. Metacarpophalangeal range of motion improved from 31.5° to 46.6°, and interphalangeal range of motion from 48.4° to 65.6°. Preoperative key pinch and grip strength were respectively 49% and 81% of contralateral values and improved to 82% and 87%. On Glickel grade, 9 cases were excellent and 7 good.
Conclusion: The novel Jobe-like figure-of-eight reconstruction technique using palmaris longus graft was useful for reconstructing irreparable thumb metacarpophalangeal joint instability without an incision on the opposite side or an additional implant.
Level of Evidence: Therapeutic study, level IV.
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Databáze: MEDLINE
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