Using Extensor Retinaculum to Reconstruct the Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament

Abstract

Chronic complete tears of the ulnar collateral ligament of the thumb metacarpophalangeal joint often require surgical reconstruction. The indications, materials used, and the methods for reconstruction remain controversial. We describe a technique for reconstruction that utilizes a slip of the extensor retinaculum for reconstruction. The advantages of extensor retinaculum as a graft choice are that it matches the native ligament with a synovial and nonsynovial surface, has elasticity similar to the ligament and minimal donor site morbidity. Reconstruction of the ulnar collateral ligament with this graft successfully restores pinch.

Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries: Management and Biomechanical Evaluation

“…Another method of reconstruction is using the extensor retinaculum. 30 A transverse incision is made over the dorsum of the wrist, and an 8-mm wide segment of the extensor retinaculum centered over the fourth extensor compartment is harvested. The synovial side faces the articular surface as the retinaculum is anchored to the origin and insertion sites with suture anchors.…”