Purpose
Acute thumb ulnar collateral ligament (UCL) tears are common injuries of the thumb
in athletes. Thumb UCL repair with suture tape augmentation is a novel procedure that
may allow earlier return to play. The purpose of this study was to evaluate the biomechanical
characteristics of the thumb after UCL repair with and without suture tape augmentation.
Methods
Eight cadaveric thumbs were tested in a custom hand testing system. Varus–valgus kinematics
were measured at –10°, 0°, 15°, and 30° of thumb metacarpophalangeal flexion under
the following conditions: (1) intact thumb UCL, (2) complete UCL tear (proper and
accessory ligaments), (3) UCL repair, and (4) UCL repair with suture tape augmentation.
Angular stiffness was also quantified after application of sequentially increasing
valgus torque in the intact UCL repair and the UCL repair with suture tape augmentation
conditions.
Results
Complete UCL tear increased total varus–valgus angulation at all degrees of thumb
metacarpophalangeal flexion. Thumb UCL repair alone and repair with suture tape augmentation
decreased total varus–valgus angulation relative to complete UCL tear at all flexion
angles. Total varus–valgus angulation was not significantly different from intact
results for either the repair alone or the repair with suture tape augmentation at
all flexion angles. Repair with suture tape augmentation had significantly higher
valgus angular stiffness compared with repair alone but not compared with intact.
Conclusions
Thumb UCL repair with suture tape augmentation is able to restore varus–valgus kinematics
after complete UCL tear without over-constraining the joint. In addition, the higher
angular stiffness afforded by the suture tape augmentation may allow for earlier rehabilitation
after surgery.
Clinical relevance
Thumb UCL repair with suture tape augmentation may allow earlier return to sport in
athletes than with repair alone.
Key words
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Article info
Publication history
Published online: November 11, 2019
Accepted:
September 25,
2019
Received:
February 4,
2019
Footnotes
This study was funded by Arthrex, Inc. who provided cadaveric specimens and implants for this study. The funding source did not play a role in the investigation.
Identification
Copyright
© 2020 by the American Society for Surgery of the Hand. All rights reserved.
