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J Hand Microsurg 2022; 14(01): 25-30
DOI: 10.1055/s-0040-1710154
Original Article

Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament: Early Outcomes of Suture Anchor Repair with Suture Tape Augmentation

Shaan S. Patel
1   Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, United States
,
Michael Hachadorian
1   Department of Orthopaedic Surgery, University of South Florida, Tampa, Florida, United States
,
Amber Gordon
2   Department of Orthopaedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, United States
,
Jason Nydick
3   Department of Hand and Upper Extremity, Florida Orthopaedic Institute, Tampa, Florida, United States
,
Michael Garcia
3   Department of Hand and Upper Extremity, Florida Orthopaedic Institute, Tampa, Florida, United States
› Author Affiliations Funding None.
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Abstract

Introduction The purpose of this study was to evaluate the early outcomes of thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) repair using suture anchors with suture tape augmentation.

Materials and Methods Six patients underwent thumb UCL repair or reconstruction with suture tape augmentation and six patients underwent thumb UCL repair with intraosseous suture anchors between January 2013 and January 2018. The main outcome measures were range of motion, strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and complications.

Results At final follow-up for patients who had suture tape augmentation, the average thumb MCP joint and interphalangeal (IP) joint flexion were 65 and 73 degrees, respectively. The average DASH score was 4.3. At final follow-up for patients who had intraosseous suture anchor repair, the average thumb MCP joint and IP joint flexion were 50 and 60 degrees, respectively. The average DASH score was 38. There were no complications or secondary procedures in either group.

Conclusion The use of suture anchor repair with suture tape augmentation for thumb UCL injuries is a treatment option that allows for early range of motion with satisfactory early outcomes that are comparable to intraosseous suture anchor repair.

Level of Evidence This is a level IV, case series article.

Keywords

thumb - ulnar collateral ligament - suture tape - repair - reconstruction


Publication History

Article published online:
28 April 2020

© 2020. Society of Indian Hand & Microsurgeons. This article is published by Thieme.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg 2011; 19 (05) 287-296
    CrossrefPubMedGoogle Scholar
  • 2 Samora JB, Harris JD, Griesser MJ, Ruff ME, Awan HM. Outcomes after injury to the thumb ulnar collateral ligament–a systematic review. Clin J Sport Med 2013; 23 (04) 247-254
    CrossrefPubMedGoogle Scholar
  • 3 Landsman JC, Seitz Jr WH, Froimson AI, Leb RB, Bachner EJ. Splint immobilization of gamekeeper’s thumb. Orthopedics 1995; 18 (12) 1161-1165
    CrossrefPubMedGoogle Scholar
  • 4 Gerber C, Senn E, Matter P. Skier’s thumb. Surgical treatment of recent injuries to the ulnar collateral ligament of the thumb’s metacarpophalangeal joint. Am J Sports Med 1981; 9 (03) 171-177
    CrossrefPubMedGoogle Scholar
  • 5 Katolik LI, Friedrich J, Trumble TE. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: a retrospective comparison of pull-out sutures and bone anchor techniques. Plast Reconstr Surg 2008; 122 (05) 1451-1456
    CrossrefPubMedGoogle Scholar
  • 6 De AF Giacomo, Shin SS. Repair of the thumb ulnar collateral ligament with suture tape augmentation. Tech Hand Up Extrem Surg 2017; 21 (04) 164-166
    CrossrefPubMedGoogle Scholar
  • 7 Kozin SH. Treatment of thumb ulnar collateral ligament ruptures with the Mitek bone anchor. Ann Plast Surg 1995; 35 (01) 1-5
    CrossrefPubMedGoogle Scholar
  • 8 Weiland AJ, Berner SH, Hotchkiss RN. McCormack RR Jr, Gerwin M. Repair of acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint with an intraosseous suture anchor. J Hand Surg Am 1997; 22 (04) 585-591
    CrossrefPubMedGoogle Scholar
  • 9 Rettig A, Rettig L, Welsch M. Anatomic reconstruction of thumb metacarpophalangeal joint ulnar collateral ligament using an interference screw docking technique. Tech Hand Up Extrem Surg 2009; 13 (01) 7-10
    CrossrefPubMedGoogle Scholar
  • 10 Moharram AN. Repair of thumb metacarpophalangeal joint ulnar collateral ligament injuries with microanchors. Ann Plast Surg 2013; 71 (05) 500-502
    CrossrefPubMedGoogle Scholar
  • 11 Lee SK, Kubiak EN, Lawler E, Iesaka K, Liporace FA, Green SM. Thumb metacarpophalangeal ulnar collateral ligament injuries: a biomechanical simulation study of four static reconstructions. J Hand Surg Am 2005; 30 (05) 1056-1060
    CrossrefPubMedGoogle Scholar
  • 12 Jarrett CD, McGillivary GR, Hutton WC. The 2.5 mm PushLock suture anchor system versus a traditional suture anchor for ulnar collateral ligament injuries of the thumb: a biomechanical study. J Hand Surg Eur Vol 2010; 35 (02) 139-143
    CrossrefPubMedGoogle Scholar
  • 13 Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am 1977; 59 (01) 14-21
    CrossrefPubMedGoogle Scholar
  • 14 Zeman C, Hunter RE, Freeman JR, Purnell ML, Mastrangelo J. Acute skier’s thumb repaired with a proximal phalanx suture anchor. Am J Sports Med 1998; 26 (05) 644-650
    CrossrefPubMedGoogle Scholar
  • 15 Werner BC, Hadeed MM, Lyons ML, Gluck JS, Diduch DR, Chhabra AB. Return to football and long-term clinical outcomes after thumb ulnar collateral ligament suture anchor repair in collegiate athletes. J Hand Surg Am 2014; 39 (10) 1992-1998
    CrossrefPubMedGoogle Scholar
  • 16 Werner BC, Belkin NS, Kennelly S. et al. Injuries to the collateral ligaments of the metacarpophalangeal joint of the thumb, including simultaneous combined thumb ulnar and radial collateral ligament injuries, in National Football League Athletes. Am J Sports Med 2017; 45 (01) 195-200
    CrossrefPubMedGoogle Scholar
  • 17 Lane LB. Acute Grade III ulnar collateral ligament ruptures. A new surgical and rehabilitation protocol. Am J Sports Med 1991; 19 (03) 234-237
    CrossrefPubMedGoogle Scholar
  • 18 Heyman P, Gelberman RH, Duncan K, Hipp JA. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing. Clin Orthop Relat Res 1993; (292) 165-171
    CrossrefPubMedGoogle Scholar
  • 19 Firoozbakhsh K, Yi IS, Moneim MS, Umada Y. A study of ulnar collateral ligament of the thumb metacarpophalangeal joint. Clin Orthop Relat Res 2002; (403) 240-247
    CrossrefPubMedGoogle Scholar
  • 20 Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med 2010; 20 (02) 106-112
    CrossrefPubMedGoogle Scholar
  • 21 Shin SS, van Eck CF, Uquillas C. Suture tape augmentation of the thumb ulnar collateral ligament repair: a biomechanical study. J Hand Surg Am 2018; 43 (09) 868.e1-868.e6
    CrossrefPubMedGoogle Scholar
  • 22 Indelicato PA. Non-operative treatment of complete tears of the medial collateral ligament of the knee. J Bone Joint Surg Am 1983; 65 (03) 323-329
    CrossrefPubMedGoogle Scholar
  • 23 Noyes FR. Functional properties of knee ligaments and alterations induced by immobilization: a correlative biomechanical and histological study in primates. Clin Orthop Relat Res 1977; (123) 210-242
    PubMedGoogle Scholar
  • 24 Coetzee JC, Ellington JK, Ronan JA, Stone RM. Functional results of open Broström ankle ligament repair augmented with a suture tape. Foot Ankle Int 2018; 39 (03) 304-310
    CrossrefPubMedGoogle Scholar