A New Technique for Reconstruction of the Ulnar Collateral Ligament of the Thumb

doi:10.1177/0363546507303663

A New Technique for Reconstruction of the Ulnar Collateral Ligament of the Thumb

From the ^*Department of Orthopaedic Surgery, New York University–Hospital for Joint Diseases, New York, New York, ^†New York University School of Medicine, New York, New York, and the ^‡Department of Orthopaedic Surgery, Jamaica Hospital Medical Center, New York, New York

Address correspondence to Nader Paksima, DO, MPH, Department of Orthopaedic Surgery, New York University, 530 First Avenue, Suite 8U, New York, NY 10016 (e-mail: npaksima{at}yahoo.com).

Abstract

Background: Several previous studies have described reconstructive methods for the treatment of an injury to the ulnar collateral ligament of the thumb. However, there are few biomechanical studies to date to analyze the strength of the surgical reconstruction.

Purpose: To evaluate 2 reconstruction techniques with use of a cadaveric model: (1) reconstruction with the use of a free tendon graft placed in a figure-of-8 fashion through drill holes in the metacarpal and proximal phalanx of the thumb, and (2) reconstruction with the use of the Bio-Tenodesis Screw System.

Study Design: Controlled laboratory study.

Methods: Eight matched pairs of cadaveric specimens underwent removal of the proper and accessory ulnar collateral ligaments. One of the 2 reconstruction methods was performed, and specimens were mounted on a materials-testing machine. The specimens were subjected to valgus stress to failure at 30° of flexion. Failure was defined as valgus laxity of 30° at the metacarpophalangeal joint.

Results: The peak load to failure was 23.5 ± 11.4 N for the figure-of-8 reconstruction and 24.3 ± 12.3 N for the reconstruction using the Bio-Tenodesis Screw System. Comparing the 2 groups, there was no statistically significant difference in peak loads to failure (P = .88).

Conclusion: There was no statistically significant difference between the peak loads to failure of the 2 reconstructions.

Clinical Relevance: The Bio-Tenodesis Screw System may provide another viable option for surgical reconstruction of the ulnar collateral ligament of the thumb.

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Footnotes

One or more authors has declared a potential conflict of interest: this experiment was carried out in an Arthrex laboratory. However, none of the authors have any financial relationship with Arthrex, and no payment was received for the study.