Sesamoidectomy and Volar Plate Repair Using Suture Anchor for Hyperextension Injury of the Metacarpophalangeal Joint of the Thumb

Kim, Byung‐Sung; Yoon, Hongkee; Park, Kang-Hee; Kim, Chang-Geun; Song, Hebok

doi:10.1142/s0218810413970034

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…If the PP of the thumb does not heal in proper position, prehensile function is lost and causes considerable functional impairment, which can progress to osteoarthritis. 24 Chronic instability of PP with persistent symptoms despite nonsurgical treatment requires surgery. Several techniques have been described: capsulodesis, sesamoid arthrodesis, and repair of PP with removable sutures or sutures in situ, with local tissue or tendon grafts.…”

Section: Discussionmentioning

confidence: 99%

Posterior dislocation of the metacarpophalangeal joint of the thumb: case report and review of literature

Victoria¹,

Eugenia²,

Guzmán³

et al. 2021

MOJAP

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Posterior dislocations of the metacarpophalangeal joint of the thumb are due to hyperextension trauma and relatively rare. We present the case of a patient in whom closed reduction was not achieved, requiring open reduction and anchoring of the palmar plate with transosseous pull out technique. A literature review focused on treatment was carried out. All authors agree that closed reduction should be the first therapeutic gesture. If this is not achieved, open reduction should be performed through a dorsal or volar approach, and there is no consensus on which is more effective, nor in terms of management of periarticular soft tissues. Reduction in this case was followed by 2-4 weeks immobilization. Results were generally good, restoring a stable and painless joint, although there might be some degree of joint stiffness.

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Section: Discussionmentioning

confidence: 99%

Posterior dislocation of the metacarpophalangeal joint of the thumb: case report and review of literature

Victoria¹,

Eugenia²,

Guzmán³

et al. 2021

MOJAP

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“…Dong et al reported the largest series of fractures to date (8). The MCP joint of the thumb was the most involved (59 cases): in 31 cases, the fractured sesamoid bone was the ulnar, in 17 the radial, and in 5 both ulnar and radial, whereas in 6, it was not reported, Other sesamoid bone fractures of the hand included 4 cases of the MCP joint of the little finger, 3 of the MCP joint of the index finger, and 1 of the MCP joint of the fourth digit . Although in the literature, fracture of the ulnar sesamoid bone of the thumb is the most reported, in our series, the radial one was more frequently injured (9 of 11 cases).…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Evaluation of Sesamoid Fractures of the Hand: Retrospective Report of 13 Patients

Bianchi¹,

Becciolini²

2018

J of Ultrasound Medicine

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S esamoid bones are small ossicles located where tendons pass over a joint. Their name is related to their appearance, resembling the oval seeds of the plant "Sesamum indicum." 1 The biomechanical role of sesamoids is not completely understood, but it seems that they reduce friction, protect tendons, and give support to joints. 2 Usually, there are 5 sesamoid bones in the hand, mainly localized at the palmar surface of metacarpophalangeal (MCP) joint. In almost 100% of the population there are 2 sesamoids at the MCP joint of the thumb. 3 Less common sesamoid bones are located at the interphalangeal joint of the thumb (53%), at the MCP joint of the index finger (43.4%), and at the MCP joint of the small finger (66.7%). 2 Exceptionally, sesamoid bones may be found in other MCP joints and interphalangeal joints. 4 Bipartite sesamoid bones were found in 0.6% to 6% of cadaveric hands. 5 The radial sesamoid bone of the thumb MCP joint is embedded within the adductor pollicis tendon, whereas the ulnar one lies inside the flexor pollicis brevis tendon. 6 The two sesamoid bones are connected to the palmar plate and play an important role in joint stability, limiting hyperextension. 7 The index sesamoid bone is frequently located on the radial aspect of the MCP joint, whereas the little finger sesamoid bone is on the ulnar side of the joint. 2 Disorders of hand sesamoid bones are mainly posttraumatic and can be seen in joint sprains, at the MCP joint of the thumb, or in direct trauma such as during falls on MCP joints of other fingers. Because of the sesamoid bones' small size and superposition of the ossicles with the adjacent bones, sesamoid bone fractures are difficult to detect on standard radiographs. Ultrasound (US) can show radiographically occult fractures. 7-10 We present a retrospective review of 13 patients with fractures of sesamoid bones of the hand detected by US.We present a review of 13 patients in whom ultrasound showed a traumatic fracture of a sesamoid of the hand. Clinically, no patients were suspected of having a sesamoid fracture. Radiographs were available in 9 patients: possible fracture of a sesamoid was reported in 1. Ultrasound showed an irregular shape, focal interruption of the bone, and avulsed fragments. In 4 patients, the diagnosis was confirmed by computed tomography. One patient with an associated ligament tear underwent surgery. The remaining patients were treated conservatively with positive outcomes at follow-up. Evaluation of the sesamoids should be part of an ultrasound examination of the hands in posttraumatic patients.

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“…However, the thumb MCP joint volar plate differs from the proximal interphalangeal joint because there is no flexor sheath proximal to the plate. Thus, no strong check rein ligaments are present [ 3 , 4 ]. The palmar ligaments consist of a thick fibrocartilaginous part distally, but in its proximal end, the volar plate becomes membranous and blends with the volar capsule, which is attached to the head of the metacarpal bone.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, ligament injury most often occurs in the proximal end of the ligament, in the metacarpal head [ 3 – 5 ]. Injury to the MCP joint volar plate of the thumb can result in serious functional impairment, producing pain and disability in the form of reduced pinch and grasp power, especially when it is not treated acutely and progresses into a chronic condition [ 3 , 4 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report

Stavropoulos,

Giannatos,

Papathanidis

et al. 2023

Am J Case Rep

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Patient: Female, 11-year-old Final Diagnosis: Volar plate injury Symptoms: Swan-neck deformity Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Rare disease Background: Volar plate injuries are rare and difficult to diagnose and treat. Only a few cases have been described on the thumb, especially in children, that resulted in swan-neck type deformity. Conservative treatment has been suggested as first-line management, but surgical reconstruction utilizing flexor digitorum superficialis tenodesis has been described for refractive cases. Only a few attempted surgical repairs of the volar plate have been reported, since it is a technically demanding procedure. Case Report: We present the case of a neglected thumb volar plate injury in an 11-year-old girl after a thumb hyperextension injury. The patient presented 2 months after her injury with functional disability of her thumb. Magnetic resonance imaging had been performed, with no signs of volar plate injury, and she was consequently treated with an extension-blocking splint, with no effect. Clinical examination raised the suspicion of a thumb volar plate injury, which was confirmed during surgical exploration. Therefore, fixation with a bone anchor was performed, and the metacarpophalangeal joint was immobilized in 20° flexion with a percutaneously inserted Kirschner wire. After splinting for 3 weeks, the patient had 10 sessions of physical therapy. At 6-week follow-up, she presented with excellent active and passive range of motion and absence of pain. Conclusions: Magnetic resonance imaging did not have high sensitivity. Six weeks after surgery, full range of motion was achieved, with no stiffness or tenderness at the first metacarpophalangeal joint, suggesting that a thumb volar plate injury had been managed surgically with a suture anchor with excellent results.

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Sesamoidectomy and Volar Plate Repair Using Suture Anchor for Hyperextension Injury of the Metacarpophalangeal Joint of the Thumb

Cited by 6 publications

References 11 publications

Posterior dislocation of the metacarpophalangeal joint of the thumb: case report and review of literature

Posterior dislocation of the metacarpophalangeal joint of the thumb: case report and review of literature

Ultrasound Evaluation of Sesamoid Fractures of the Hand: Retrospective Report of 13 Patients

Surgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report

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