Reconstruction of Chronic Thumb Metacarpophalangeal Radial Collateral Ligament Injuries with Free Tendon Grafts

Abstract

Objectives: This study aims to review our reconstruction methodto treat chronic grade 3 thumb metacarpophalangeal (MP) jointradial collateral ligament (RCL) tears using free tendon grafts.Patients and methods: Thirteen male patients (mean age 41 years;range, 20 to 67 years) who received a free tendon graft totreat chronic grade 3 thumb MP joint RCL injury betweenMay 2016 and July 2018 were evaluated prospectively. Patientswith incomplete bone maturation (n=1), those who had additionalinjuries in the same extremity (n=1), and those who had previouslyundergone surgery on the same extremity (n=1) were excluded. TheDisabilities of the Arm, Shoulder and Hand (DASH) questionnairewas used for functional evaluation and the visual analog scale(VAS) was also used for pain evaluation.Results: The decrease in DASH (p=0.008) and VAS (p=0.03)scores and the increase in grip (p=0.031) and pinch strength(p=0.006) between the preoperative and final follow-up valueswere statistically significant. No ulnar deviation was observed inX-rays at the final examination, nor was MP joint radial instabilityobserved under ulnar stress during clinical examinations. In twopatients, 1 and 1.5 mm palmar subluxation was observed at finalexamination. The other 11 patients had no palmar subluxation atfinal examination.Conclusion: Although ours is a more complicated methodcompared to other reconstruction approaches, we think that it is asuitable alternative for achieving joint stability and good functionalresults.