Metacarpophalangeal joint fusion was performed on 36.3% (4/11) of patients with RCL (N=1) and UCL (N=3) tears. The original study using this tool had a mean quality score range of 25% to 96% but had more than half of the studies scoring >75%. POST-OPERATIVE WEEKS 22-24. Both repair and reconstruction (autograft and allograft) techniques were inclusive. There is currently no consensus on treatment of acute or chronic UCL injuries.
Athletes Can Return to Play in Half the Time with New Thumb Ligament 2.
Outcomes After Injury to the Thumb Ulnar Collateral Ligament - Medscape Kozin SH, Bishop AT. The mean postoperative follow up time was 105.4 days (13-617) and mean time to complication was 71.6 days (13-293). Doi: 10.1177/2325967118769328. Ulnar collateral ligament (UCL) rupture is often seen in patients practicing sports activities, particularly in ski falls. 2014 Dec;33(6):384-9. doi: 10.1016/j.main.2014.10.003. Furthermore, it is interesting that our study quality results using the Quality Appraisal Tool were as low as they were (mean 54% with a range of 33%-79%). Nonoperative treatment of acute UCL injury (with or without a Stener lesion) frequently fails, leading to chronic pain, instability, and weakness, eventually prompting surgical intervention.. Key, pulp, and tip pinch and grip strength were either equivalent or only mildly weak compared with the contralateral thumb and hand in all subjects. A postsearch criterion of exclusion included expert opinion level V evidence studies or outcomes after management of radial collateral ligament (RCL) injury of the thumb. Ford GM, Genuario J, Kinkartz J, Githens T, Noonan T. Am J Sports Med. The UCL of the thumb acts as a primary restraint to valgus stress and is injured if hyperabduction and hyperextension forces are applied to the first metacarpophalangeal joint. Through a small incision along the side of the thumb joint, we will see where the ligament was torn.
Hand Surgery Recovery Time: Pain, Exercise & Complications Therefore, the purpose of this systematic review is to combine patient outcomes from multiple unique studies and analyze the results of treatment of thumb UCL injury to determine the following: The authors hypothesized that no difference exists in clinical outcomes between repair and reconstruction for acute UCL injury. 415 Ray C Hunt Drive, Suite 3200 Charlottesville, VA 22903 434-982-HAND (4263) This systematic review has demonstrated excellent clinical outcomes (pain, strength, motion, and stability) after surgical treatment (repair and autograft reconstruction) of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. This article provides a review of . The UCL has as its central function maintenance of ulnar stability of the joint, which is paramount for pinch grip. For example, it can be removed when performing . For this elbow surgery, the internal brace is most appropriate for the athlete that has a UCL sprain that is not complex. [41] Abrahamsson et al[42] maintain that a proximally displaced ligament, palpated proximal to the MP joint, is a more specific indication for surgery. Gamekeepers thumb: a prospective study of functional bracing. 7. eCollection 2021 Apr. gamekeeper's thumb; skier's thumb; stener lesion; ulnar collateral ligament, NOW OVER 19K FOLLOWERS ON TWITTER. Commonly, the joint will be permanently enlarged due to the scarring of the healing process. What are the symptoms of GameKeeper's Thumb? The ulnar collateral ligament (UCL) of the thumb is commonly injured by falling onto an outstretched hand or in sports where the thumb metacarpal phalangeal joint (MP) is hyperextended or hyper-abducted. 2009;34:304308. FOIA Bean CH, Tencer AF, Trumble TE. 1992;8:713732. Lohman M, Vasenius J, Nieminen O, et al.. MRI follow-up after free tendon graft reconstruction of the thumb. Samora, Julie Balch MD, PhD*; Harris, Joshua D. MD; Griesser, Michael J. MD; Ruff, Michael E. MD*; Awan, Hisham M. MD*. Eventually this abnormal movement will wear out the joint and it will become arthritic. 2020 Apr 28;13(4):228-231. doi: 10.1055/s-0040-1709098. 21. may email you for journal alerts and information, but is committed
A broken thumb usually causes more intense pain, and your thumb may look deformed or misshapen. Proximal interphalangeal joint injuries of the hand. Bennet Fracture. Metacarpophalangeal joint motion ranged from 79% to 100% compared with the contralateral thumb. The overall complication rate after primary thumb RCL and UCL repair was 13.8%. A broken thumb can also cause numbness or tingling. The site is secure. Usually it is pulled off of the bone (proximal phalanx) on the nail side of the joint. Any hard force on the thumb that pulls the thumb away from the hand (called a valgus force) can cause damage to the ulnar collateral ligaments. Erickson BJ, Harris JD, Chalmers PN, Bach BR Jr, Verma NN, Bush-Joseph CA, Romeo AA. UCL repair surgery is a procedure to treat an injury to the UCL, the soft tissue that connects the bones of the thumb and provides stability to the thumb joint.
Ulnar Collateral Ligament Injuries of the Thumb - Panther When untreated, this injury may lead to decreased pinch strength, pain, instability, and. Epub 2019 Mar 21. Some injuries can be associated with a Stener lesion, which is displacement of the ruptured ligament proximal to the adductor aponeurosis, effectively precluding healing without operative treatment.6, Acute injuries can be treated with immobilization or surgically with direct repair using bone anchors, direct repair using bone tunnels and pullout sutures, or tension band fixation of bony avulsions.79 If an injury is chronic, there are several operative treatment options, including ligament reconstruction with tendinous autograft or allograft, bonesoft tissuebone autograft, or even fusion of the MP joint.1012. modify the keyword list to augment your search. Educate the patient on anti edema management. Clin J Sport Med. Nonoperative treatment led to high patient satisfaction for acute thumb UCL injury in 2 studies.23,29 Thirty-two subjects were treated with thumb-spica immobilization (30 were proximal phalanx avulsion fractures). Bookshelf Danilkowicz RM, O'Connell RS, Satalich J, O'Donnell JA, Flamant E, Vap AR. Further detection bias existed in that not all studies used each clinical outcome (eg, Glickel grade) or radiographic measure postoperatively. National Library of Medicine Thumb ulnar collateral ligament (UCL) tears occur commonly in elite athletes. Thumb sprain may cause bruising, tenderness, and swelling around the base of the thumb. UCLR techniques associated with the highest rates of neuropathy were detachment of the FPM, modified Jobe fixation, and concomitant ulnar nerve transposition, although it remains unclear whether there is a causal relationship between these factors and subsequent development of postoperative ulnar neuropathy due to limitations in the current body of published literature. 2015 Nov-Dec;7(6):511-7. doi: 10.1177/1941738115607208. Griffith TB, Ahmad CS, Gorroochurn P, D'Angelo J, Ciccotti MG, Dines JS, Altchek DW, Camp CL. Modified Jobe Versus Docking Technique for Elbow Ulnar Collateral Ligament Reconstruction: A Systematic Review and Meta-analysis of Clinical Outcomes. Epub 2014 Dec 30. There is, however, agreement on the treatment goals for repair or reconstruction of the UCL, which are to obtain and maintain an anatomic reduction of the MP joint, reproduce the anatomic origin and the insertion of native ligament, ensure sufficient strength to allow early range of motion, and minimize donor site morbidity if autograft is used. Obremskey W, Pappas N, Attallah-Wasif E, et al.. Levels of evidence in Orthopaedic Journals. J Bone Joint Surg Am. Sports injuries accounted for most of the remaining injuries, with only 2.4% acquired as a result of skiing injuries. This injury happens when an ulnar collateral ligament (UCL) tough and flexible tissue that connect bones in the thumb gets stretched too far or tears. 1,6,15 The mechanism of injury is a radially directed force on an extended thumb, which can occur when an athlete falls onto an abducted thumb, slides into a baseball base, or attempts to catch a ball. Bone-periosteum-bone graft reconstruction for chronic ulnar instability of the metacarpophalangeal joint of the thumbminimum 5-year follow-up evaluation. three muscles provide deforming forces at the base of the thumb. Only 1 study reported significant loss of either MP and interphalangeal joint motion (P < 0.005).25 Except for 2 patients with significant postoperative weakness, full or near-full strength (key pinch and grip) was restored in all studies. A secondary purpose was to compare graft choice and surgical technique for reconstruction. [15,39] It is not entirely clear why patients fail nonoperative treatment, but some authors contend that failure may be because of irreducible displacement of the ruptured ligament. Pain, range of motion, key-pinch strength, and stability testing were used as outcome measures. Mean study follow-up was 42.8 months. 1961;43-A:541546. 2021 Nov 23;9(11):23259671211055428. doi: 10.1177/23259671211055428. Looney AM, Wang DX, Conroy CM, Israel JE, Bodendorfer BM, Fryar CM, Pianka MA, Fackler NP, Ciccotti MG, Chang ES. Please enable it to take advantage of the complete set of features! Rupture and displacement of the. A Novel Surgical Reconstruction Technique in the Management of Chronic Ulnar Collateral Ligament Tears with Volar Subluxation.
Ulnar Collateral Ligament (UCL) Repair | SpringerLink 1989;14:567573. Exercises: Progress to Phase II throwing (once successfully completed Phase I) POST-OPERATIVE WEEK 30-32 .
Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries Hand Injuries - Finger Tip Injuries, Jersey Finger, PIP Dislocations