Literature DB >> 28836462

A Biomechanical Evaluation of a 2-Suture Anchor Repair Technique for Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries.

Joseph A Gil1, Alison Chambers1, Kalpit N Shah1, Joseph J Crisco1, Christopher Got1, Edward Akelman1.   

Abstract

BACKGROUND: A complete thumb ulnar collateral ligament (UCL) repaired with 1-suture anchor has been demonstrated to be significantly weaker compared with the intact UCL. The objective of this study is to test the biomechanical strength of a 2-anchor thumb UCL repair.
METHODS: Nine paired fresh-frozen hands were used for this biomechanical analysis. One thumb from each pair was randomized to the control group and one to the repair group. In the control group, the UCL was loaded to failure in tension. In the repair group, the UCL was dissected off of the proximal phalanx, subsequently repaired with a 2-anchor technique, and then tested to failure.
RESULTS: The mean yield load was 342 N (95% confidence interval [CI], 215-470 N) in the control group and 68 N (95% CI, 45-91 N) in the repair group. The mean maximum load at failure was 379 N (95% CI, 246-513 N) in the control group and 84 N (95% CI, 62-105 N) in the repair group. The mean stiffness was 72 N/m (95% CI, 48-96 N/m) in the control group and 17 N/m (95% CI, 13-21 N) in the repair group. The mean displacement at failure was 7.8 mm (95% CI, 7-9 mm) in the control group and 7.8 mm (95% CI, 7-9 mm) in the repair group.
CONCLUSIONS: The 2-anchor repair technique we tested does not acutely reestablish the strength of the insertion of the native insertion of the UCL with this technique.

Keywords:  gamekeeper’s thumb; skier’s thumb; thumb ulnar collateral ligament; thumb ulnar collateral ligament injury; thumb ulnar collateral ligament repair

Mesh:

Year:  2017        PMID: 28836462      PMCID: PMC6109898          DOI: 10.1177/1558944717725380

Source DB:  PubMed          Journal:  Hand (N Y)        ISSN: 1558-9447


  16 in total

1.  Acute skier's thumb repaired with a proximal phalanx suture anchor.

Authors:  C Zeman; R E Hunter; J R Freeman; M L Purnell; J Mastrangelo
Journal:  Am J Sports Med       Date:  1998 Sep-Oct       Impact factor: 6.202

2.  Acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint: an anatomical and clinical study.

Authors:  J Arranz López; F Alzaga; J Molina
Journal:  Acta Orthop Belg       Date:  1998-12       Impact factor: 0.500

Review 3.  Thumb metacarpophalangeal joint collateral ligament injury management.

Authors:  Arthur T Lee; Michelle G Carlson
Journal:  Hand Clin       Date:  2012-08       Impact factor: 1.907

4.  Acute gamekeeper's thumb. Quantitative outcome of surgical repair.

Authors:  D J Downey; M S Moneim; G E Omer
Journal:  Am J Sports Med       Date:  1995 Mar-Apr       Impact factor: 6.202

5.  Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing.

Authors:  P Heyman; R H Gelberman; K Duncan; J A Hipp
Journal:  Clin Orthop Relat Res       Date:  1993-07       Impact factor: 4.176

Review 6.  Gamekeeper's thumb. Early diagnosis and treatment.

Authors:  S H Kozin; A T Bishop
Journal:  Orthop Rev       Date:  1994-10

7.  Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures.

Authors:  M Dinowitz; T Trumble; D Hanel; N B Vedder; M Gilbert
Journal:  J Hand Surg Am       Date:  1997-11       Impact factor: 2.230

Review 8.  Outcomes after injury to the thumb ulnar collateral ligament--a systematic review.

Authors:  Julie Balch Samora; Joshua D Harris; Michael J Griesser; Michael E Ruff; Hisham M Awan
Journal:  Clin J Sport Med       Date:  2013-07       Impact factor: 3.638

9.  A biomechanical modeling of injury, repair, and rehabilitation of ulnar collateral ligament injuries of the thumb.

Authors:  Brian J Harley; Frederick W Werner; Jason K Green
Journal:  J Hand Surg Am       Date:  2004-09       Impact factor: 2.230

10.  Collagen-platelet composites improve the biomechanical properties of healing anterior cruciate ligament grafts in a porcine model.

Authors:  Braden C Fleming; Kurt P Spindler; Matthew P Palmer; Elise M Magarian; Martha M Murray
Journal:  Am J Sports Med       Date:  2009-03-31       Impact factor: 6.202

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  1 in total

Review 1.  Nonreconstruction Options for Treating Medial Ulnar Collateral Ligament Injuries of the Elbow in Overhead Athletes.

Authors:  Nicholas J Clark; Vishal S Desai; Joshua D Dines; Mark E Morrey; Christopher L Camp
Journal:  Curr Rev Musculoskelet Med       Date:  2018-03
  1 in total

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