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BONE-RETINACULUM-BONE RECONSTRUCTION OF METACARPOPHALANGEAL INSTABILITY OF THE THUMB



Abstract

Introduction: The metacarpophalangeal joint of the thumb is prone to frequent injury in the capsule and collateral ligaments, especially the ulnar collateral ligament. Delayed diagnosis, inappropriate treatment or progressive laxity of the ligament complex can lead to chronic instability of the MCP joint of the thumb. Various surgical repair procedures have been described.

We present the surgical procedure consisting of a bone-retinaculum-bone autograft taken from the second tunnel of the flexor retinaculum of the carpus.

Purpose: Our purpose is to present the experience of seven cases in which chronic instability of the thumb was treated using a bone-retinaculum-bone autograft.

Materials and methods:

Type of study: Descriptive

Period: 2003–2004

Number of cases: 7 (4 women and 3 men) aged 23 to 65

Injury-to-surgery time more than one year

Results:

  • - We achieved stability of the MCP joint in all cases.

  • - The metacarpophalangeal and interphalangeal joint balance was not diminished.

  • - The grasp force was sustained at over 80% of that of the healthy side.

  • - Two elderly women were not employed; the other five returned to their previous jobs.

Conclusions: Given the results obtained, we think this is an excellent method for deferred reconstruction of thumb instability and, although it involves considerable technical difficulty, we feel it is an option to bear in mind for this type of injury.

The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain