Outcomes in repair of the ulnar collateral ligament of the thumb metacarpophalangeal joint

Outcomes in repair of the ulnar collateral ligament of the thumb metacarpophalangeal joint The ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (MCPJ) is an important stabilising structure that is frequently injured. A variety of methods have been described to repair the ligament, many of which are used in our unit. A retrospective audit of short-term outcomes was combined with a longer term follow-up study to help identify factors that might influence outcomes and to provide information regarding long-term morbidity which could be used to counsel future patients undergoing UCL repair. Forty-nine patients underwent repair of their UCL over a 5-year period. The commonest complication recorded at an average follow-up of 3.5 months was MCPJ stiffness. A further 11 patients were assessed at an average time of 29 months following surgery. The mean visual analogue scores were 2.5 for stiffness, 2.8 for pain and 2.5 for cold intolerance. Quick-DASH scores averaged 15. The commonest functional problems reported by the patients were in jar opening and in activities requiring a firm grip. Subgroup analysis showed statistically significant differences in tripod and key grip when compared to normal values ( p = 0.03, key grip; p = 0.01 tripod grip, paired t test). Buck-Gramcko scores for the thumb were graded as excellent in eight patients and as good in three patients. Repair of the ulnar collateral ligament of the thumb provides a good functional result with few complications with any hand surgeon performing their favoured technique. The patient should be warned of the possibility of long-term weakness in grip when consenting for surgery. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Plastic Surgery Springer Journals

Outcomes in repair of the ulnar collateral ligament of the thumb metacarpophalangeal joint

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Publisher
Springer-Verlag
Copyright
Copyright © 2012 by Springer-Verlag
Subject
Medicine & Public Health; Plastic Surgery
ISSN
0930-343X
eISSN
1435-0130
D.O.I.
10.1007/s00238-011-0663-1
Publisher site
See Article on Publisher Site

Abstract

The ulnar collateral ligament (UCL) of the thumb metacarpophalangeal joint (MCPJ) is an important stabilising structure that is frequently injured. A variety of methods have been described to repair the ligament, many of which are used in our unit. A retrospective audit of short-term outcomes was combined with a longer term follow-up study to help identify factors that might influence outcomes and to provide information regarding long-term morbidity which could be used to counsel future patients undergoing UCL repair. Forty-nine patients underwent repair of their UCL over a 5-year period. The commonest complication recorded at an average follow-up of 3.5 months was MCPJ stiffness. A further 11 patients were assessed at an average time of 29 months following surgery. The mean visual analogue scores were 2.5 for stiffness, 2.8 for pain and 2.5 for cold intolerance. Quick-DASH scores averaged 15. The commonest functional problems reported by the patients were in jar opening and in activities requiring a firm grip. Subgroup analysis showed statistically significant differences in tripod and key grip when compared to normal values ( p = 0.03, key grip; p = 0.01 tripod grip, paired t test). Buck-Gramcko scores for the thumb were graded as excellent in eight patients and as good in three patients. Repair of the ulnar collateral ligament of the thumb provides a good functional result with few complications with any hand surgeon performing their favoured technique. The patient should be warned of the possibility of long-term weakness in grip when consenting for surgery.

Journal

European Journal of Plastic SurgerySpringer Journals

Published: Oct 1, 2012

References

  • Ligament reconstruction with or without tendon interposition to treat primary thumb carpometacarpal osteoarthritis. A prospective randomized study
    Kriegs-Au, G; Petje, G; Fojtl, E; Ganger, R; Zachs, I
  • Ulnar collateral ligament injuries of the thumb: 10 years of surgical experience
    Chuter, GSJ; Muwanga, CL; Irwin, LR

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