Thumb metacarpophalangeal ulnar collateral ligament injuries: A biomechanical simulation study of four static reconstructions

Steve K. Lee, Erik N. Kubiak, Ericka Lawler, Kazuho Iesaka, Frank A. Liporace, Steven M. Green

Research output: Contribution to journalArticlepeer-review

39 Scopus citations

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 languageEnglish
Pages (from-to)1056-1060
Number of pages5
JournalJournal of Hand Surgery
Volume30
Issue number5
DOIs
StatePublished - Sep 2005
Externally publishedYes

Keywords

  • Metacarpophalangeal
  • Reconstruction
  • Thumb
  • Ulnar collateral ligament

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