Abstract
Aims: We evaluated a novel modification of a technique presented by Drey and Eaton (1993). The need of temporary K-wire fixation of the MP joint was questioned by randomisation. Methods: 30 consecutive patients with late instability of the thumb UCL were randomised in two groups (group1: K-wire fixation of the MP joint for 6 weeks, group 2: no internal fixation) and operated on. External immobilisation was used for 6 weeks in both groups. The follow-ups including clinical examination, X-rays and MRI study (10 patients) were at 8 weeks, 12 and 24 months. So far 26 patients have been followed up for 1 year and 15 patients for 2 years. Results: Stability of the MP joint improved from preop.(average yield) 58o (56°vs.59°= group 1 vs. group 2, n.s.) to 18° (17° vs. 19°n.s.) at one year and to 26°(20°vs. 30°n.s.) at 2 years. Compared to the uninjured hand key pinch strength improved from preop. 74% (81% vs. 69% n.s.) to 95% (97% vs. 93% n.s.) at 1 year and to 100% (102% vs. 98% n.s.) at 2 years. The pulp pinch strength improved from preoperative 65% (68% vs. 63% n.s.) to 98% (98% vs. 97% n.s.) at 1 year and to 108% (109% vs. 107% n.s.) at two years. 18 (69%) of 26 patients (73% vs. 67%) followed at least 1 year revealed the result as good or excellent, 6 (23%) patients (27% vs. 20%) revealed the result as fair and 3 (12%) patients (9% vs.13%) revealed the result as poor. All patients returned to their previous work. Conclusions: This new technique provided good improvement in stability and strength of the thumb. Temporary K-wire fixation of the MP joint seems to have no influence on the outcome so far.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
