Diagnosis by Ultrasound of Dislocated Ulnar Collateral Ligament of the Thumb

1995 ◽  
Vol 36 (4-6) ◽  
pp. 620-625 ◽  
Author(s):  
M. Höglund ◽  
P. Tordai ◽  
C. Muren
Keyword(s):  
Surgical Repair ◽  
Ultrasound Examination ◽  
Ulnar Collateral Ligament ◽  
Collateral Ligament ◽  
Severe Lesion

The ability of ultrasound to assess a displaced ulnar collateral ligament of the 1st metacarpo-phalangeal (MCP) joint was evaluated. If the ligament is ruptured and displaced proximal to the adductor aponeurosis, a surgical repair should be undertaken to restore stability. Ultrasound accurately diagnosed these lesions in 32/39 operated patients. In 4 cases the ultrasound examination suggested a more severe lesion than was found at operation. In 3 cases a lesser injury was suspected than later proved to be present.

Reefing Procedure for Lateral Collateral Ligament Attenuation during Ligamentous Repair for Elbow Trauma

2012 ◽  
Vol 4 (4) ◽  
pp. 277-281
Author(s):  
Benjamin W. Sears ◽  
Grant E. Garrigues ◽  
Dan Witmer ◽  
Matthew L Ramsey
Keyword(s):  
Surgical Repair ◽  
Lateral Collateral Ligament ◽  
Ulnar Collateral Ligament ◽  
Current Procedural Terminology ◽  
Collateral Ligament ◽  
Elbow Trauma ◽  
Code Search ◽  
Lateral Ulnar Collateral Ligament ◽  
Humeral Condyle ◽  
A Current

Background Injury to the lateral soft tissue structures is common after complex elbow trauma and instability. Typically, this consists of lateral collateral ligamentous complex avulsion from the lateral distal humeral condyle. However, in some cases, attenuation of the ligament midsubstance may also occur, potentially resulting in residual ligamentous laxity after repair. Methods From 2007 to 2011, 37 patients were identified through a current procedural terminology code search as having undergone lateral ulnar collateral ligament (LUCL) repair during surgery for trauma to their elbow and were retrospectively reviewed. Results Attenuation of the ligament midsubstance was found in 19% (seven of 37) patients who underwent surgical repair of the LUCL for injuries to the elbow. In these patients, direct repair of the ligament with additional reefing of the ligament midsubstance was performed. Retrospective review of this population revealed no postsurgical instability or need for subsequent stabilizing procedures. Conclusions These findings demonstrate that, in select patients, repair with reefing of an attenuated LUCL ligament promotes stability to the elbow.

Acute Skier's Thumb Repaired With a Proximal Phalanx Suture Anchor

1998 ◽  
Vol 26 (5) ◽  
pp. 644-650 ◽  
Author(s):  
Craig Zeman ◽  
Robert E. Hunter ◽  
John R. Freeman ◽  
Mark L. Purnell ◽  
Jackie Mastrangelo
Keyword(s):  
Functional Outcome ◽  
Suture Anchor ◽  
Surgical Repair ◽  
Proximal Phalanx ◽  
Ulnar Collateral Ligament ◽  
Ligament Repair ◽  
Collateral Ligament ◽  
Ligament Rupture ◽  
A New Technique ◽  
Postoperative Interval

The purpose of this study was to determine the functional outcome of a surgical technique for the repair of injuries of the ulnar collateral ligament of the thumb. A 14-point questionnaire was developed to determine functional outcome after surgical repair of acute ulnar collateral ligament rupture. Early ulnar collateral ligament repair was performed on 58 patients with grade III sprains (complete rupture) of the ligament using a new technique that employs a suture anchor for fixation. Forty-five patients were interviewed at a minimum postoperative interval of 12 months and were included in this study. Forty-four patients (98%) believed they had a stable repair, were satisfied with their surgery, and would have it again if necessary. Forty-four patients (98%) were not hindered in their day-to-day activities and had a functional range of motion. Mild discomfort was felt by eight of our patients (17%), but only three patients (7%) had pain with activities. The average time to return to skiing was 1.7 days. The use of a suture anchor provided a strong and stable repair if the surgery was performed early.

scholarly journals Early Return to Play With Thumb Spica Gauntlet Casting for Ulnar Collateral Ligament Injuries Complicated by Adjacent Joint Dislocations in Collegiate Football Linemen

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 92-96 ◽  
Author(s):  
Derek T. Bernstein ◽  
Patrick C. McCulloch ◽  
Leland A. Winston ◽  
Shari R. Liberman
Keyword(s):  
Surgical Repair ◽  
Return To Sport ◽  
Ulnar Collateral Ligament ◽  
Return To Play ◽  
Additional Stress ◽  
Collateral Ligament ◽  
Spica Casting ◽  
Joint Dislocations ◽  
The Mean

Background: Treatment of thumb ulnar collateral ligament (UCL) ruptures in elite athletes aims to restore thumb stability while minimizing lost playing time. Thus, surgical repair with early protected return to play in a thumb spica cast has been advocated. The purpose of this study was to document adjacent joint dislocations after primary surgical repair sustained during protected return to play with thumb spica casting in elite-level football players. Methods: Three Division I collegiate starting linemen sustaining adjacent joint dislocations in thumb spica casts following acute surgical repair of ipsilateral thumb UCL ruptures were retrospectively reviewed. Demographic data were recorded as well as the timeline for injury, treatment, and subsequent return to sport. Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores were obtained at final follow-up. Results: The mean time from thumb UCL injury to surgical repair was 8.7 days, and the mean return to sport was 13.3 days from surgery. There were 4 simple dislocations including 3 proximal interphalangeal (PIP) joints and 1 elbow. Each PIP dislocation was close reduced and treated with buddy straps with immediate return to play. The elbow dislocation was close reduced and splinted with return to play 22 days after injury. The mean QuickDASH score was 2.3 at 12 month follow-up. Conclusions: This report highlights that while thumb spica casting protects the surgically repaired thumb UCL and allows for earlier return to play, it risks placing additional stress upon adjacent joints and therefore adjacent injury. Appropriate counseling of the risks and benefits of this treatment strategy is essential.

Wrapping of the Medial Ulnar Collateral Ligament

2011 ◽  
Author(s):  
Amin M. Motlagh ◽  
Mark Carl Miller
Keyword(s):  
Soft Tissue ◽  
Surgical Repair ◽  
Ulnar Collateral Ligament ◽  
Medial Epicondyle ◽  
Surgical Reconstruction ◽  
Joint Stability ◽  
Collateral Ligament ◽  
Valgus Stress ◽  
Substantial Impact ◽  
Bundle Structure

The multi-bundle structure of the medial ulnar collateral ligament (mUCL) has been documented [1] and it is known that the anterior bundle of the mUCL is the primary restraint to valgus stress of the elbow [2–5]. It has also been documented that the anterior band of this bundle becomes taut in extension whereas the posterior band becomes taut in flexion [1]. The mUCL is frequently injured in the throwing athlete due to over use or extreme valgus load. In order to reconstruct the ligament, surgical repair may be required. It has been experimentally observed in our lab and in other labs that the UCL wraps around the medial epicondyle. One of the parameters to ensure achievement of a successful surgical reconstruction may be the re-establishment of the natural wrapping behavior of UCL around the epicondyle. Previous studies [6] also suggest that soft-tissue wrapping constraints have substantial impact on joint stability. This study begins to characterize the wrapping of the two bands in the anterior bundle of UCL in terms of the location along the ligament’s length and flexion angle to establish native behavior.

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