The late reconstruction of the ligament of the metacarpo-phalangeal joint of the thumb.

The disruption of the ligaments at the level of the MP-joint jeopardizes the function by lack of stability. The reconstruction by free tendon grafting, anchored in a dorso-lateral plane in the metacarpal an in the proximal phalanx, restores stability and good functional results in spite of a slight amount of loss of flexion. Two out of 25 operated thumbs failed and fusion of the MP-joint was necessary. A minimal limitation of flexion may be desirable since a tendon graft never restores a full physiological function. Our data show no need for K-wire transfixation of the MP-joint, since there is no evidence of a difference in late stability with or without such additional fixation. The mean pinch-grip pressure, restored to normal in the majority of cases, was not influenced by the mentioned reduction of flexion nor by the amount of stability restored.