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

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.

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Results of tension band wiring in intra-articular collateral ligament avulsion fractures of the phalanx

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v6i2.19807 ◽

2018 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Rajeev Raj Manandhar ◽

Shishir Lakhey ◽

Umash Karki

Keyword(s):

Functional Outcome ◽

Soft Tissues ◽

Proximal Phalanx ◽

Ring Finger ◽

Ulnar Collateral Ligament ◽

Tension Band ◽

Tension Band Wiring ◽

Collateral Ligament ◽

Avulsion Fractures ◽

Radial Collateral Ligament

Background: Avulsion fractures of the base of proximal phalanx associated with ulnar or radial collateral ligament instability are relatively rare. The small size of the fragment and strong deforming pull of the attached soft tissues make the process of reduction and maintenance difficult.Objective: The purpose of this study was to assess the functional outcome of tension band wiring in intra-articular avulsion fractures of the base of the proximal phalanx.Methodology: A prospective study was performed on ten patients with intra-articular collateral ligament avulsion fractures of the proximal phalanx (Jupiter’s classification Type III). A tension band construct was performed using a dorsal approach. The functional outcome was assessed at six months with the quick Disability of Arm, Shoulder and Hand score.Results: The mean age of the patients was 25.8 years (Mean ± SD: 25.80). Six avulsion fractures were of the ulnar collateral ligament of the proximal phalanx of the index finger, one involved the radial collateral ligament of the ring finger and three, the radial collateral ligament of the little finger suggesting an abduction injury. All fractures had united at three months. Eight patients were graded as excellent and two as good. All patients were satisfied with the surgery and the functional outcome of the injured digit. There were no perioperative complications.Conclusion: The functional outcome of tension band wiring in intra-articular collateral ligament avulsion fractures of the base of the proximal phalanx was good to excellent.

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10 Ulnar collateral ligament (UCL) ruptureThumbSkierSkier thumbMetacarpophalangeal joint (MCPJ)ulnar collateral ligament rupture inThumb MCP Joint Ulnar Collateral Ligament Repair

Hand Trauma: Illustrated Surgical Guide of Core Procedures ◽

10.1055/b-0038-161078 ◽

2018 ◽

Keyword(s):

Ulnar Collateral Ligament ◽

Ligament Repair ◽

Collateral Ligament ◽

Ligament Rupture

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A Biomechanical Evaluation of a 2-Suture Anchor Repair Technique for Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries

Hand ◽

10.1177/1558944717725380 ◽

2017 ◽

Vol 13 (5) ◽

pp. 581-585 ◽

Cited By ~ 5

Author(s):

Joseph A. Gil ◽

Alison Chambers ◽

Kalpit N. Shah ◽

Joseph J. Crisco ◽

Christopher Got ◽

...

Keyword(s):

Suture Anchor ◽

Proximal Phalanx ◽

Ulnar Collateral Ligament ◽

Maximum Load ◽

Biomechanical Analysis ◽

Control Group ◽

Collateral Ligament ◽

Repair Technique ◽

The Mean ◽

Repair Group

Background: A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair. Methods: Nine paired fresh-frozen hands were used for this biomechanical analysis. One thumb from each pair was randomized to the control group and one to the repair group. In the control group, the UCL was loaded to failure in tension. In the repair group, the UCL was dissected off of the proximal phalanx, subsequently repaired with a 2-anchor technique, and then tested to failure. Results: The mean yield load was 342 N (95% confidence interval [CI], 215-470 N) in the control group and 68 N (95% CI, 45-91 N) in the repair group. The mean maximum load at failure was 379 N (95% CI, 246-513 N) in the control group and 84 N (95% CI, 62-105 N) in the repair group. The mean stiffness was 72 N/m (95% CI, 48-96 N/m) in the control group and 17 N/m (95% CI, 13-21 N) in the repair group. The mean displacement at failure was 7.8 mm (95% CI, 7-9 mm) in the control group and 7.8 mm (95% CI, 7-9 mm) in the repair group. Conclusions: The 2-anchor repair technique we tested does not acutely reestablish the strength of the insertion of the native insertion of the UCL with this technique.

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Elbow joint laxity after experimental radial head excision and lateral collateral ligament rupture: Efficacy of prosthetic replacement and ligament repair

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2004.05.009 ◽

2005 ◽

Vol 14 (1) ◽

pp. 78-84 ◽

Cited By ~ 67

Author(s):

Steen Lund Jensen ◽

Bo Sanderhoff Olsen ◽

Stein Tyrdal ◽

Jens Ole Søjbjerg ◽

Otto Sneppen

Keyword(s):

Radial Head ◽

Elbow Joint ◽

Lateral Collateral Ligament ◽

Joint Laxity ◽

Prosthetic Replacement ◽

Ligament Repair ◽

Collateral Ligament ◽

Ligament Rupture ◽

Radial Head Excision

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Arthroscopically-assisted fixation of anteromedial coronoid facet fracture and lateral ulnar collateral ligament repair for acute posteromedial rotatory fracture dislocation of the elbow

Shoulder & Elbow ◽

10.1177/1758573217738138 ◽

2017 ◽

Vol 11 (5) ◽

pp. 378-383 ◽

Cited By ~ 2

Author(s):

Abbas Rashid ◽

David Copas ◽

Jeremy Granville-Chapman ◽

Adam Watts

Keyword(s):

Articular Surface ◽

Ulnar Collateral Ligament ◽

Fracture Dislocation ◽

Ligament Repair ◽

Collateral Ligament ◽

Coronoid Fracture ◽

Elbow Arthroscopy ◽

Lateral Ulnar Collateral Ligament ◽

Arthroscopically Assisted ◽

Facet Fracture

If left untreated, varus posteromedial rotatory injuries of the elbow result in poor functional outcomes. Surgical treatment allows restoration of elbow kinematics, minimizing the chances of chronic varus instability and early onset osteoarthritis. However, large exposures are associated with extensive soft tissue stripping, a high risk of infection, nerve injury, poor visualization of the articular surface and longer recovery. Consequently, there has been renewed interest in the use of elbow arthroscopy to circumvent these problems. Arthroscopic treatment offers the potential advantage of a swift recovery, with instant rehabilitation, less stiffness and swelling than might be expected after open repair. We present the first combined arthroscopic-assisted anteromedial facet coronoid fracture fixation and lateral ulna collateral ligament repair in a varus posteromedial rotatory injury of the elbow.

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