A New Technique for Reconstruction of the Ulnar Collateral Ligament of the Thumb

Baskies, Michael A.; Tuckman, David V.; Paksima, Nader; Posner, Martin A.

doi:10.1177/0363546507303663

Cited by 27 publications

(14 citation statements)

References 22 publications

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“…The only way to make certain that these biological methods are of value is through validated outcome measures. At this point, only biomechanical outcomes are validated via direct readings from tensile testing systems [1,3,9]. There are several, objective grading systems for looking at cartilage repair that include the Pineda scale [14,15], the International Cartilage Repair Society cartilage repair assessment score [13], the O'Driscoll scale [14], and the Oswestry Arthroscopy Score [19].…”

Section: Introductionmentioning

confidence: 99%

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

et al. 2010

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Much current research is focused on biologic enhancement of the tendon repair process. To evaluate the different methods, which include a variety of gene therapy and tissue engineering techniques, histological and biomechanical testing is often employed. Both modalities offer information on the progress and quality of repair; however, they have been historically considered as two separate entities. Histological evaluation is a less costly undertaking; however, there is no validated scoring scale to compare the results of different studies or even the results within a given study. Biomechanical testing can provide validated outcome measures; however, it is associated with increased cost and is more labor intensive. We hypothesized that a properly developed, objective histological scoring system would provide a validated outcome measure to compare histological results and correlate with biomechanics. In an Achilles tendon model, we have developed a histological scoring scale to assess tendon repair. The system grades collagen orientation, angiogenesis, and cartilage induction. In this study, histology scores were plotted against biomechanical testing results of healing tendons which indicated that a strong linear correlation exists between the histological properties of repaired tendons and their biomechanical characteristics. Concordantly, this study provides a pragmatic and financially feasible means of evaluating repair while accounting for both the histology and biomechanical properties observed in surgically repaired, healing tendon.

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Section: Introductionmentioning

confidence: 99%

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

et al. 2010

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“…Small interference screws simplify the bony fixation of the tendon graft and experimental data support their strength. 16 A modification of the Fusetti method using an interference screw is described in this paper (Fig. 1).…”

Section: Historical Perspectivementioning

confidence: 99%

Anatomic Double-Bundle Reconstruction With Free Tendon Graft for Chronic Ulnar Instability of the Thumb Metacarpophalangeal Joint

Rigó¹

2014

Techniques in Hand &Amp; Upper Extremity Surgery

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Failed primary treatment of thumb metacarpophalangeal ligament injuries may lead to chronic instability. Different treatments have been described such as secondary ligament suture, fusion, dynamic or static procedures. Techniques to restrain the joint stability with various grafts of different configurations have been published, but most of these address only the proper collateral ligament. Experimental data revealed the importance of the accessory collateral ligament in stabilizing the metacarpophalangeal joint. In a former, true anatomic ligament reconstruction a bone-tendon graft was used; the tendon was split longitudinally to reconstruct both parts of the collateral ligament. This technique was modified by the author: a resorbable interference screw was used to fix a free tendon graft double in the metacarpal head, creating 2 identical bundles for reconstruction of both the proper and the accessory collateral ligament. The results of the first 10 patients with chronic ulnar instability in their otherwise intact thumb are reported. The mean follow-up was 15 months. Eight patients had excellent result and 2 patients had good result according to the Glickel grading system. The mean loss of motion in the metacarpophalengeal joint was 9% and the mean loss of pinch strength was 9% compared with the contralateral thumb. The technical details, pitfalls, complications, and rehabilitation are described in this paper.

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“…A Stener lesion arises when the adductor aponeurosis interposes and obstructs the UCL from its torn insertion preventing healing and leading to chronic thumb instability. 17 One biomechanical study compared the strength of the 2.5-mm PushLock suture anchor (Arthrex Inc., Naples, FL) with a traditional Bio-SutureTak (Arthrex Inc., Naples, FL) in 18 specimens and found no difference in the load to failure between the two suture anchors. These injuries should be identified and repaired to prevent long-term morbidity.…”

Section: Skier's Thumbmentioning

confidence: 99%

Latest techniques in the management of thumb fractures

Bachoura

Shin

2012

Current Orthopaedic Practice

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Among the digits, the thumb's anatomy is unique. Thumb fractures require special treatment considerations since inappropriate management can compromise pinch, grasp, and overall hand function. This article reviews the most common types of thumb phalangeal and metacarpal injuries. The literature is presented in the context of the latest operative treatment trends, techniques, and hardware. At the current time, there are numerous surgical techniques that can be used to manage various thumb fractures. However, few gold standards have been established, and the technique choice often is dictated by the surgeon's preferences and experience. In addition, currently available data on thumb injuries often are presented in the context of all finger injuries. Well-controlled comparative and biomechanical studies exclusive to thumb fracture treatment can ultimately establish treatment standards.

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A New Technique for Reconstruction of the Ulnar Collateral Ligament of the Thumb

Abstract: The Bio-Tenodesis Screw System may provide another viable option for surgical reconstruction of the ulnar collateral ligament of the thumb.

Cited by 27 publications

References 22 publications

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

Histologic Stages of Healing Correlate with Restoration of Tensile Strength in a Model of Experimental Tendon Repair

Anatomic Double-Bundle Reconstruction With Free Tendon Graft for Chronic Ulnar Instability of the Thumb Metacarpophalangeal Joint

Latest techniques in the management of thumb fractures

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