Repair of Acute Ulnar Collateral Ligament Injuries of the Thumb Metacarpophalangeal Joint: A Retrospective Comparison of Pull-Out Sutures and Bone Anchor Techniques

被引:54
作者
Katolik, Leonid I.
Friedrich, Jeffrey [1 ]
Trumble, Thomas E.
机构
[1] Univ Washington, Div Plast Surg, Dept Surg, Sch Med, Seattle, WA 98104 USA
关键词
D O I
10.1097/PRS.0b013e3181882163
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: The use of intraosseous suture anchors in the treatment of ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint has previously been described. However, no direct comparisons exist of ulnar collateral ligament repair with bone anchor versus repair with a pull-out button and immobilization. Methods: Two cohorts of patients with complete rupture of the ulnar collateral ligament of the thumb metacarpophalangeal joint were compared. Thirty patients in each cohort underwent repair of the ulnar collateral ligament with either an intraosseous suture anchor followed by early mobilization or a pull-out suture tied over a button with cast immobilization. Average follow-up was 29 months. Results: At follow-up, range of motion at the metacarpophalangeal and interphalangeal joints for the anchor group averaged 97 percent of that of the contralateral side compared with 86 percent and 87 percent, respectively, for the button group. For the anchor group, pinch strength averaged 101 percent that of the contralateral side compared with 95 percent for the button group. No significant difference was noted between the groups for grip strength. Average tourniquet time for the anchor group was 28 minutes compared with 43 minutes for the button group. Soft-tissue complications were present in 27 percent of patients (eight of 30) in the pull-out button group compared with 7 percent (two of 30) in the anchor group. Cost analysis demonstrates an approximately $140-per-patient savings when using the suture anchor. Conclusions: Both repair methods are safe and effective for treating thumb ulnar collateral ligament injuries. Suture anchors allow for an accelerated rehabilitation protocol, which may account for the improved range of motion and pinch strength at follow-up. (Plast. Reconstr. Surg. 122: 1451, 2008.)
引用
收藏
页码:1451 / 1456
页数:6
相关论文
共 25 条
[1]  
Bean CHG, 1999, J HAND SURG-AM, V24A, P283
[2]   ULNAR COLLATERAL LIGAMENT INJURY OF THE THUMB - TREATMENT WITH GLOVE SPICA CAST [J].
CAMPBELL, JD ;
FEAGIN, JA ;
KING, P ;
LAMBERT, KL ;
CUNNINGHAM, R .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1992, 20 (01) :29-30
[3]   Failure of cast immobilization for thumb ulnar collateral ligament avulsion fractures [J].
Dinowitz, M ;
Trumble, T ;
Hanel, D ;
Vedder, NB ;
Gilbert, M .
JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 1997, 22A (06) :1057-1063
[4]   ACUTE GAMEKEEPERS THUMB - QUANTITATIVE OUTCOME OF SURGICAL REPAIR [J].
DOWNEY, DJ ;
MONEIM, MS ;
OMER, GE .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1995, 23 (02) :222-226
[5]   Treatment of "gamekeeper's thumb" by reconstruction of the ulnar collateral ligament [J].
Fairhurst, M ;
Hansen, L .
JOURNAL OF HAND SURGERY-BRITISH AND EUROPEAN VOLUME, 2002, 27B (06) :542-545
[6]   SKIERS THUMB - SURGICAL-TREATMENT OF RECENT INJURIES TO THE ULNAR COLLATERAL LIGAMENT OF THE THUMBS METACARPOPHALANGEAL JOINT [J].
GERBER, C ;
SENN, E ;
MATTER, P .
AMERICAN JOURNAL OF SPORTS MEDICINE, 1981, 9 (03) :171-177
[7]   LIGAMENT REPLACEMENT FOR CHRONIC INSTABILITY OF THE ULNAR COLLATERAL LIGAMENT OF THE METACARPOPHALANGEAL JOINT OF THE THUMB [J].
GLICKEL, SZ ;
MALERICH, M ;
PEARCE, SM ;
LITTLER, JW .
JOURNAL OF HAND SURGERY-AMERICAN VOLUME, 1993, 18A (05) :930-941
[9]  
HEYMAN P, 1993, CLIN ORTHOP RELAT R, P165
[10]   GAMEKEEPERS THUMB - A QUANTITATIVE-EVALUATION OF ACUTE SURGICAL REPAIR [J].
JACKSON, M ;
MCQUEEN, MM .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 1994, 25 (01) :21-23