Dorsoradial ligament imbrication for thumb carpometacarpal joint instability

Dorsoradial ligament imbrication is a direct and effective alternative to ligament reconstruction or metacarpal osteotomy in patients with symptomatic thumb carpometacarpal (CMC) joint instability. This procedure is performed by imbricating either the trapezial or the metacarpal attachment of the dorsoradial ligament with the use of a suture anchor. The procedure is indicated in the setting of chronic hyperlaxity or instability of the thumb CMC joint. Significant arthritic changes in the thumb CMC joint are a contraindication for this procedure. We present our technique along with an anatomic dissection to demonstrate the ligament and surgical procedure on an anatomic specimen. We also present results from 3 patients who underwent this technique with images and clinical results for 3 patients with long-term follow-up.