La reconstruction ligamentaire secondaire de la métacarpo-phalangienne du pouce (MPI)

The ECRL bone-tendon ligamentoplasty for chronic ulnar instability of the metacarpophalangeal joint of the thumb

“…Breek et al [24] noted that one-third of the patients had some loss of flexion/extension, with no significant disability. Our results come closest to the ones reported by Glickel et al [14] and Guelmi et al [18] with, respectively, 4% and 8% of ROM loss and are superior to those obtained by Sennwald et al [10] who found a mean loss of 19°. Smith and De Santolo [6], in a series of 25 patients who had collateral ligament repair with a tendon graft, noted an average loss of motion of 20°, concluding that partial loss of movement was preferable to total arthrodesis.…”

“…In most published cases, the palmaris longus tendon was used for surgical stabilization of the first MCP joint [2,4,6,[8][9][10][11][14][15][16][17]. Some authors make use of the flexor carpi radialis and abductor pollicis longus tendons or tensor fasciae latae [1,10,12,14]. Synthetic ligamentoplasties have also been proposed [13,21].…”

“…Our patients experienced an average loss of motion of 10% and a satisfactory stability. Although classic or more recent ligamentoplasties often show satisfactory outcome in terms of stability [10,11,14,17,18], several authors [7,10,11] noted persistent pain or reduced range of motion of the metacarpophalangeal joint. Breek et al [24] noted that one-third of the patients had some loss of flexion/extension, with no significant disability.…”

“…Various surgical techniques have been described for the treatment of chronic ulnar ligament insufficiency of the metacarpophalangeal (MCP) joint of the thumb: simple suture of the remains of the ligament, static or dynamic ligamentoplasties [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] or, in cases of symptomatic degenerative arthritis, arthrodesis of the MCP joint. The results cannot be compared because of the small number of cases in several reports and the variability of objective criteria in the follow-ups.…”

Spätergebnisse nach operativer Behandlung frischer und chronischer Instabilitäten des ulnaren Daumenseitenbandes

“…Der alleinige Bandersatz ergibt im Vergleich zur Versetzung des Adduktorenansatzes eine bessere Beweglichkeit bei etwas geringerer Stabilitä t [22,25]. Bessere Ergebnisse erzielen die Bandersatzplastiken unter Verwendung von Lyodura oder autologem Sehnenmaterial.…”