Ulnar Collateral Ligament Reconstruction of Thumb Metacarpophalangeal Joint With Adductor Pollicis Tendon Using the Wide-Awake Approach

Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet Surgery

“…7 A, B). 17 Specifically, after suturing once between the APL and FCR tendons, the pinching movement between the thumb and fingertips of each finger has been confirmed. In particular, patients are instructed to check whether the tip of the thumb reaches the high metacarpophalangeal joint of the small finger (Kapandji score, 10).…”

“…We previously devised and reported a simpler method for ligament reconstruction using the adductor pollicis tendon. 17 The adductor pollicis tendon can be also an option when palmaris longus is absent.…”

“…15 It is helpful to apply the WALANT technique before surgery because the tension and stability of the reconstructed ligament can be confirmed by having the patient perform a lateral knob movement automatically after fixation. 17

Figure 6 Ligament reconstruction for ulnar collateral ligament injury of the thumb metacarpophalangeal joint. The half-slip tendon is moved and fixed with a suture anchor to reconstruct the ligament.

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

“…5 Existen numerosas técnicas estáticas y dinámicas descritas en la bibliografía para la reconstrucción del LCU, y entre ellas se destacan las plastias capsulares, transferencias dinámicas de tendones, e injertos libres de tendones. [6][7][8][9][10][11] Sin embargo, adaptándonos a los avances de los implantes y a la tendencia del empleo de cirugía menos agresiva, el propósito de este trabajo es presentar una técnica quirúrgica versátil de reconstrucción anatómica del LCU con injerto del tendón del músculo palmaris longus, que, siguiendo la tendencia de las cirugías percutáneas, produce menor cantidad de tejido cicatricial, disminuye el número de complicaciones, como infecciones, adherencias y rigideces, y acelera el tiempo de retorno laboral y deportivo. [12][13][14][15]…”