Thumb metacarpophalangeal ulnar collateral ligament injuries : A biomechanical simulation study of four static reconstructions

Steve K LEE; Erik N KUBIAK; Ericka LAWLER; Kazuho IESAKA; Frank A LIPORACE; Steven M GREEN

doi:10.1016/j.jhsa.2005.05.004

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Journal article

Thumb metacarpophalangeal ulnar collateral ligament injuries : A biomechanical simulation study of four static reconstructions

Steve K LEE, Erik N KUBIAK, Ericka LAWLER, Kazuho IESAKA, Frank A LIPORACE and Steven M GREEN

The Journal of hand surgery (American ed.), Vol.30A(5), pp.1056-1060

2005

DOI: 10.1016/j.jhsa.2005.05.004

PMID: 16182067

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Abstract

Purpose To determine the optimal tunnel placement positions for tendon graft reconstruction of chronic thumb metacarpophalangeal (MCP) ulnar collateral ligament injuries that would stabilize the joint while maintaining motion. Methods Four commonly used tunnel placement methods were simulated on a cadaveric model using fresh-frozen thumbs and a suture/screw construct. The methods were as follows: (1) triangular configuration with apex proximal, (2) triangular configuration with apex distal, (3) cruciate configuration, and (4) parallel configuration. Stability was tested by valgus loading at 0° and 30°, and range of motion was tested by loading the thumb tendons. Statistical analysis was performed by 1-way analysis of variance testing. Results Valgus load stability testing at 0° and 30° showed that all 4 reconstruction methods stabilized the MCP joint compared with the fully sectioned state. The amount of stability achieved was not significantly different between the 4 methods. Only the reconstruction method, however, with a triangular configuration with the apex proximal restored flexion/extension range of motion not significantly different from the intact state. The other 3 methods resulted in significantly decreased range of motion. Conclusions The reconstruction tunnel positioning of triangular configuration with apex proximal stabilizes the thumb MCP joint while maintaining flexion/extension range of motion. We recommend this configuration for chronic MCP joint injuries in which the native ulnar collateral ligament is inadequate and tendon graft reconstruction is performed.

Biological and medical sciences

Orthopedic surgery

Medical sciences

Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases

Details

Title: Subtitle: Thumb metacarpophalangeal ulnar collateral ligament injuries : A biomechanical simulation study of four static reconstructions
Creators: Steve K LEE - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Erik N KUBIAK - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Ericka LAWLER - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Kazuho IESAKA - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Frank A LIPORACE - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Steven M GREEN - Department of Orthopaedic Surgery, Hospital for Joint Diseases/New York University School of Medicine, New York, NY, United States
Resource Type: Journal article
Publication Details: The Journal of hand surgery (American ed.), Vol.30A(5), pp.1056-1060
Publisher: Elsevier; New york, NY
DOI: 10.1016/j.jhsa.2005.05.004
PMID: 16182067
ISSN: 0363-5023
eISSN: 1531-6564
Language: English
Date published: 2005
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040305802771

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