Anatomic Reconstruction of Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Using an Interference Screw Docking Technique

Abstract

Complete rupture of the ulnar collateral ligament injury of the thumb metacarpophalangeal (MCP) joint can be a debilitating injury resulting in decreased grip and pinch strength. The spectrum of injury to this ligament varies from simple strain to complete rupture of both proper and accessory ligaments. Generally, this is a result of an abduction force transmitted across the thumb MCP joint.Physical examination assists in identification of these injuries and the extent of ligamentous injury. Ecchymoses and pain over the ligament are usually present in the acute injury. Chronic injuries may not be painful. A palpable mass may be present. The valgus stress test across this joint in 30 degrees of flexion provides information on the competency of the proper ligaments, whereas valgus stress in extension assesses the accessory collateral ligaments. This stress test is useful in the acute or chronic setting.Stabilization of the thumb MCP joint in chronic injuries can require reconstruction. We describe an anatomic reconstruction using a tendon graft and a bioabsorbable interference screw.

Thumb collateral ligament injuries in the athlete

“…Many techniques have been described for repair of acute UCL tears, including pullout sutures over bone tunnels [10,28,35,36], suture buttons [10,36], suture anchors [37][38][39][40], interference docking screws [41], condylar shaving with suture anchors [42], and arthroscopic repair [43]. Katolik et al [35] compared two groups of 30 patients treated with bone tunnels with pullout sutures and suture anchors.…”

Percutaneous Reconstruction of the Ulnar Collateral Ligament of the Metacarpophalangeal Joint of the Thumb: Technique and Results

“…Rettig et al 22 describieron una técnica abierta utilizando tornillos interferenciales con una disposición triangular del injerto. Fue en 2017 que Jiménez et al 23 compararon, en estudio cadavérico de reconstrucción del LCU con injerto tendinoso, banda simple versus banda doble, y no encontraron diferencias significativas en cuanto a estabilidad, congruencia articular, movilidad, ángulo de valgo, y fuerza, con propiedades biomecánicas comparables.…”

Thumb Carpometacarpal Arthroplasty Using an Absorbable Interference Screw for Flexor Carpi Radialis Ligament Reconstruction

“…4 In a cadaveric study by Lee et al (2005), 5 interference screw fixation provided higher pullout strength and stiffness than bone suture anchors and sutures tied over a polyethylene button. 4 In a cadaveric study by Lee et al (2005), 5 interference screw fixation provided higher pullout strength and stiffness than bone suture anchors and sutures tied over a polyethylene button.…”