Thumb Metacarpophalangeal Ulnar Collateral Ligament Injuries: A Biomechanical Simulation Study of Four Static Reconstructions

Injury to the Ulnar Collateral Ligament of the Thumb

“…Historically, cast immobilization for 4 to 6 weeks in an acute injury was recommended regardless of the stability of the MCPJ [4,27]. Currently, most authors have agreed with Stener opinion that 75% of the cases will fail to heal when there is complete rupture of the ulnar collateral ligament of the thumb [10,13,24,33] though Pichora et al in 1989 reported very good results with bracing. Limitations of this study, however, are 25% dropout rates, and at some cases, a 3-month immobilization [30].…”

Chronic Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Insufficiency

“…However, this procedure did not restore stability to volar translation and abnormal supination at the MCP joint past 60°and 45°of flexion, respectively. Lee et al 19 biomechanically compared the results of triangular (apex distal and proximal), figure-of-eight, and rectangular free tendon graft reconstructions and noted that all methods resulted in a stable MCP joint to valgus loading in 0°and 30°without any significant differences between methods. However, only the apex proximal configuration restored range of motion similar to that of a normal MCP joint, whereas the other configurations resulted in decreased range of motion.…”

Collateral ligament injuries of the metacarpophalangeal joint of the thumb: a treatment algorithm

“…Lee et al [48] demonstrated that this was the only configuration to restore range of motion in the plane of flexion and extension comparably to the uninjured side. Furthermore, Hogan et al [49] demonstrated that whilst no reconstruction could fully replicate the strength of an uninjured UCL, the triangular configuration with a proximal apex using an interference knot fails at a much higher moment than the other configurations thereby providing the strongest reconstruction.…”