Arch Hand Microsurg.  2018 Dec;23(4):254-261. 10.12790/ahm.2018.23.4.254.

Comparison between Chronic Ulnar and Radial Collateral Ligament Repairs in the Metacarpophalangeal Joint of the Thumb

• Lee S
• Ha J
• Kim JY
• Jeon SH

• KMID: 2427391
• DOI: http://doi.org/10.12790/ahm.2018.23.4.254

Abstract

PURPOSE
Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint.
METHODS
We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically.
RESULTS
The average of postoperative ulnar deviation angle was 13.3° in radial ligament and 2.0° in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs.
CONCLUSION
The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.

Keyword

Thumb; Metacarpophalangeal joint; Collateral ligament; Suture anchors

MeSH Terms

Collateral Ligaments*
Follow-Up Studies
Joints
Ligaments
Metacarpophalangeal Joint*
Retrospective Studies
Rupture
Suture Anchors
Thumb*

Figure

• 

  Fig. 1 (A) Distal ulnar collateral ligament (UCL) ruptured site is thin and changed into a translucent granulation tissue (arrow). (B) Detachment site is well observed with over-pronation of the thumb. (C) UCL was reattached with an absorbable suture anchor and the joint capsule was repaired.

• 

  Fig. 2 (A) Preoperative X-ray of radial collateral ligament (RCL) rupture shows mild ulnar deviation and volar subluxation. (B) Retracted proximal RCL is thin and translucent. (C) Postoperative X-ray. (D) X-ray at 4 years postoperatively shows increased deformity of the joint and osteolysis around a metal anchor.

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