Abstract
Injuries to the ulnar collateral ligament (UCL) of the metacarpophalangeal joint of
the thumb are common and may result in functional instability of the joint. Eight
cadaveric hands were studied. Physiologic levels of muscle loads were applied to the
extrinsic flexor tendon of the thumb to simulate tip pinch of the thumb. We investigated
the effects of transection of the UCL and accessory UCL (UCL complex) with and without
transection of the dorsal capsule and volar plate and of reconstruction of the UCL,
for 2 surgical techniques, on the position of the proximal phalanx with respect to
the thumb metacarpal. The spatial positions of the metacarpal and proximal phalanx
were measured with a 6° of freedom digitizing system for flexion angles from 0° to
60° in 15° increments. Transection of the UCL complex, dorsal capsule, and volar plate
(ulnar capsuloligamentous structures) of the metacarpophalangeal joint did not affect
radioulnar deviation or radioulnar shift, but did produce significant increases in
supination by 8° and volar translation by 2 mm at 45° and 60° compared with those
found for the intact joint. The UCL was reconstructed with a tendon graft using the
autogenous extensor digiti quinti. The first surgical technique, a traditional technique,
and the second surgical technique, a technique based on anatomy, returned the position
of the proximal phalanx on the metacarpal head to normal, with the exceptions of volar
translation of the proximal phalanx at 60° and trends toward abnormal supination of
the proximal phalanx for flexion angels of 45° and 60°. (J Hand Surg 2000;25A:313–321.
Copyright © 2000 by the American Society for Surgery of the Hand.)
Keywords
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Article info
Publication history
Accepted:
November 24,
1999
Received:
February 1,
1999
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Louis F. Draganich, PhD, Department of Surgery, Section of Orthopaedics and Rehabilitation Medicine, The University of Chicago Medical Center, 5841 S Maryland Ave/MC 3079, Chicago, IL 60637.
*0363-5023/00/25A02-0022$3.00/0
**J Hand Surg 2000;25A:313–321
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
