A Quantitative Evaluation of Thumb Function after Ulnar Collateral Repair and Reconstruction

Reconstruction of the ulnar collateral ligament of the thumb metacarpophalangeal joint: A cadaver study

“…All of the reconstructions as described by Strandell, 11 Osterman et al, 12 None of the reconstructions approached the strength and stiffness of the native UCL. Statistical analysis of the data showed that serial testing of the specimens did not have any significant effect on the moment at failure, rotational stiffness, angle at failure, or mode of failure of each reconstruction.…”

“…1,2,[11][12][13][14][15][16][17][18][19][20][21] In contrast to the predictable recovery of function after acute repair, the poorer tissue quality seen in chronic injuries leads to a higher frequency of recurrent instability. Although small numbers have been reported, the long-term integrity is restored in 50% 1 to 75%, 19 with diminished recovery of pinch strength.…”

“…13,17 These uncertainties have led to the description of various ligament reconstructions using dynamic, static, or a combination of both dynamic and static restraints to prevent abnormal joint motion. Dynamic reconstructions use tendon advancement (adductor pollicis) 12,13,16 or tendon transfer (extensor indicis, extensor pollicis longus, or extensor pollicis brevis) 18 to increase the adduction moment on the thumb proximal phalanx during pinch, thereby restoring joint stability. The results from these procedures are variable, with some reports approaching the favorable results seen after acute repairs.…”

“…The clinical results of these interventions vary, ranging from 50% to greater than 90% restoration of joint stability. 1,3,[11][12][13][14][15][16][17][18][19][20][21] The biomechanical characteristics of the native and acutely repaired UCL have been described. 22 The purpose of this study was to compare the stiffness and strength of the native UCL with the characteristics of the ligament reconstruction techniques described by Strandell, 11 Osterman et al, 12 Fairhurst and Hansen, 13 and a modification of the procedure by Glickel et al 14 We hypothesized that none of the ligament reconstructions would approximate the stiffness and strength of the native UCL.…”

Thumb collateral ligament injuries in the athlete

“…Parameters to record are the degrees of valgus laxity in full extension and 30°flexion, injured and contralateral, and presence of an end point. Laxity of 30°, increased laxity of 15°compared to the contralateral side, or lack of endpoint signify injury [17][18][19]. Laxity in full extension indicates accessory UCL or volar plate tear and in 30°flexion, tear of the proper UCL.…”