Abstract
Purpose: To determine the optimal tunnel placement positions for tendon graft reconstruction of chronic thumb metacarpophalangeal (MCP) ulnar collateral ligament injuries that would stabilize the joint while maintaining motion. Methods: Four commonly used tunnel placement methods were simulated on a cadaveric model using fresh-frozen thumbs and a suture/screw construct. The methods were as follows: (1) triangular configuration with apex proximal, (2) triangular configuration with apex distal, (3) cruciate configuration, and (4) parallel configuration. Stability was tested by valgus loading at 0°and 30°, and range of motion was tested by loading the thumb tendons. Statistical analysis was performed by 1-way analysis of variance testing. Results: Valgus load stability testing at 0°and 30°showed that all 4 reconstruction methods stabilized the MCP joint compared with the fully sectioned state. The amount of stability achieved was not significantly different between the 4 methods. Only the reconstruction method, however, with a triangular configuration with the apex proximal restored flexion/extension range of motion not significantly different from the intact state. The other 3 methods resulted in significantly decreased range of motion. Conclusions: The reconstruction tunnel positioning of triangular configuration with apex proximal stabilizes the thumb MCP joint while maintaining flexion/extension range of motion. We recommend this configuration for chronic MCP joint injuries in which the native ulnar collateral ligament is inadequate and tendon graft reconstruction is performed.
Original language | English |
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Pages (from-to) | 1056-1060 |
Number of pages | 5 |
Journal | Journal of Hand Surgery |
Volume | 30 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2005 |
Externally published | Yes |
Keywords
- Metacarpophalangeal
- Reconstruction
- Thumb
- Ulnar collateral ligament