Purpose
To evaluate a reconstructive method for chronic radial collateral ligament (RCL) injuries
of the thumb metacarpophalangeal (MCP) joint using a combination of RCL advancement
and the transfer of a half-slip of the abductor pollicis brevis tendon.
Methods
Eight patients (4 male and 4 female; mean age, 25 y) with chronic RCL injury of the
thumb MCP joint were enrolled. All patients were referred to our institution because
of continuing pain and instability on the radial side of the MCP joint when grasping
or pinching objects. The mechanism of the injury was adduction stress to the thumb
during sporting activities in 5 patients, a heavy object falling on the thumb in 1,
and a fall in 2. The mean duration from RCL injury to surgery was 20 weeks. The average
postoperative follow-up was 51 months. We evaluated postoperative outcomes including
pain, range of motion of the thumb MCP joint, grip strength, key pinch strength, Disabilities
of the Arm, Shoulder, and Hand score, and ability to return to preinjury work or sporting
activities.
Results
No patients demonstrated continuing symptoms, and the MCP joint was stable after surgery.
Postoperative grip and pinch strength (37 and 6.3 kg, respectively) were increased
compared with preoperative values (34 and 3.9 kg, respectively). All patients returned
fully to their preinjury work or sporting activities within 6 months after surgery.
Although postoperative flexion was decreased by an average of 6°, no patients noted
functional deficiency.
Conclusions
We recommend the reconstructive method of RCL advancement and transfer of a half-slip
of the abductor pollicis brevis tendon to alleviate pain and improve grip and pinch
strength in chronic RCL injuries of the thumb MCP joint.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: August 07, 2013
Accepted:
June 14,
2013
Received:
February 21,
2013
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
