These movements include opposing the thumb to each finger, thumb extension/abduction and full wrist movement. 11. The effect of thumb metacarpophalangeal. A broken thumb can also cause numbness or tingling. 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. National Library of Medicine HHS Vulnerability Disclosure, Help eCollection 2021 Mar. Am J Sports Med. Comparison of Outcomes Based on Graft Type and Tunnel Configuration for Primary Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers. If the tear is diagnosed later a ligament reconstruction might be a better option. Complications If the UCL is ruptured there is a possibility that the distal end may become interposed by the adductor aponeurosis, which is referred to as a Stener lesion (Figure 5). Accessibility Instability of the metacarpophalangeal joint of the thumb. I wore a custom plastic splint that immobilized the MCP joint but allowed me to move the IP joint for 8 weeks total. Sports Health. The injury happens when you fall . 2013;23(4):247-254. By nature of the definition of chronic UCL deficiency, patients with remote UCL injury have either been untreated or have failed prior nonoperative treatment (for various reasons such as pain, weakness, or instability) and gone on to necessitate surgical intervention. Your thumb will be immobilized in a splint and should not be moved until follow up. 35. 20. 2013Lippincott Williams & Wilkins. Thirty-two thumbs were treated nonoperatively and 261 operatively. 1987;214:113120. It runs from the outer humerus, around the radial head and attaches to the ulna. J Hand Surg Am. No study directly compared the different types of graft for UCL reconstruction. eCollection 2022 Jan. Gnanasekaran D, Raveendranath V, Karupusamy A. J Hand Microsurg. No study directly compared the clinical outcome between repair and reconstruction of the thumb UCL for acute (less than 3 weeks) or chronic UCL injury. Evidence-based use of clinical examination, ultrasonography, and MRI for diagnosing ulnar collateral ligament tears of the metacarpophalangeal joint of the thumb: systematic review and meta-analysis. Ulnar collateral ligament tear represents 60 percent of upper limb problems in skiers and is frequently overlooked and underdiagnosed. UCLR case series that contained complications data were included. Wong TC, Ip FK, Wu WC. Clinical outcome studies after nonoperative or operative treatment of thumb UCL injuries, with a minimum of 2 years mean follow-up, were included. FOIA If you log out, you will be required to enter your username and password the next time you visit. Symptoms of the UCL injury include pain, instability of the MCP joint of the thumb, and weakness in prehension and the chronicity of the injury. [16] Despite these study limitations, this systematic review is strong in that it analyzes the largest number of studies and subjects in the literature managed with both nonoperative and operative means for acute and chronic UCL injury. J Bone Joint Surg Am. TREATMENT: Treatment consists of either a period of splintage or if completely torn,a repair of the ligament with an operation. Erickson BJ, Harris JD, Chalmers PN, Bach BR Jr, Verma NN, Bush-Joseph CA, Romeo AA. Reconstruction of the collateral ligaments using the extensor pollicis brevis tendon. Knowledge of the anatomy and accurate physical examination are essential in the evaluation of a patient with skier's thumb. 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. 2015 Apr;46(2):281-92. doi: 10.1016/j.ocl.2014.11.007. The ECRL bone-tendon ligamentoplasty for chronic ulnar instability of the metacarpophalangeal joint of the thumb. A blunt self-retainer is used to retract the musculature, and a small periosteal elevator can be used to clean any remaining muscle fibers from the UCL. Causes. 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. Evaluation and management of elbow injuries in the adolescent overhead athlete. Danilkowicz RM, O'Connell RS, Satalich J, O'Donnell JA, Flamant E, Vap AR. Increase in Use of Medial Ulnar Collateral Ligament Repair of the Elbow: A Large Database Analysis. Thorough literature review to define the question, Specific inclusion and exclusion criteria, Appropriate scope of psychometric properties, Sample size calculation and justification, Authors referenced specific procedures for administration, scoring, and interpretation of procedures, Valid conclusions and clinical recommendations, 96% good and excellent outcomes* with stable joint, pain relief, restored strength, and 85% motion retention, 100% good and excellent outcomes,* 85% without pain, 70% without laxity, 82% strength retention, and 79% motion retention, 100% good and excellent outcomes,* 100% without pain or instability, 89% strength retention, and 90% motion retention, 100% stability, 96% key pinch strength retention, and 106% pulp pinch strength retention, 89% without pain, 89% pinch strength retention, 93% grip strength retention, and 74% motion retention, 100% good and excellent outcomes,* 90% strength retention, and 92% motion retention, 100% stability, 100% strength retention, and 100% motion retention, Both returned to previous level of sport and function, Compared intraosseous suture anchor and early mobilization to pullout suture or button and cast immobilization, Both groups significantly improved outcomes, 9 had suture periosteal repair; 1 had pullout suture repair, 31% loss of motion at MP joint; 10% loss of motion at IP joint, Arthroscopic Stener reduction and K-wire MP immobilization, No patient had loss of motion .10 degrees, 8 ligament repairs; 1 anchor; 1 drill hole; 4 K-wire fixations of avulsion, No detectable residual UCL laxity in 10 patients, 2 had less than 15 degrees laxity, 7 pullout suture and K-wire MP immobilization; 25 periosteal soft tissue suture, Palmaris longus via bone tunnels with or without K-wire fixation MP joint, Iliac crest boneperiosteumbone with cortical screw fixation, ECRL bonetendon ligamentoplasty with 1.5-mm titanium screw and suture anchor fixation, Palmaris longus via bone tunnels with K- ire fixation MP joint, 20 excellent, 4 good, and 2 fair results*. Bean CH, Tencer AF, Trumble TE. There were 200 acute injuries and 93 chronic injuries. Transfer bias was present in the difference of length of follow-up, despite a minimum of 2 years, and the proportion of subjects who enrolled and completed that which was actually followed up. Rehabilitation and Return-to-Play Criteria Following Ulnar Collateral Ligament Reconstruction. Before Physical examination of the thumb demonstrates the instability of the MCP joint, impossibility of opposition of the thumb, and the weakening of gripping force.5,6 For all statistical analysis within all studies analyzed, P < 0.05 was deemed significant. Search performed on November 17, 2011. 1 Major components of the TFCC are the articular disc (AD), meniscus homolog, radioulnar ligaments, and extensor carpi . Data range was reported as minimum to maximum absolute values. Wolters Kluwer Health Please enable it to take advantage of the complete set of features! Nonoperative treatment often failed, necessitating surgery. 32. Deep infections around the tendons and bones are rare and may need admission to hospital for intravenous antibiotics and further surgery. We sought to address a gap in the literature by comparing thumb metacarpophalangeal (MCP) joint angle measurements and biomechanical strength before complete, acute UCL tear and after . 4. 1996;25:527530. Please enable scripts and reload this page. Please enable it to take advantage of the complete set of features! Management of thumb metacarpophalangeal ulnar collateral ligament injuries. Clin J Sport Med. Furthermore, the lack of patient-specific data precluded advanced statistical calculations, and weighted means from individual studies were the basis for comparison. A systematic review of multiple medical databases was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines with specific inclusion and exclusion criteria. Patel SS, Hachadorian M, Gordon A, Nydick J, Garcia M. J Hand Microsurg. Orthop J Sports Med. Complications, failures, and reoperations are rare after surgical treatment of UCL injury. Complications after surgical treatment of UCL injury are rare. If the latter was executed only partially, a score of 1 was assigned. your express consent. Griffith TB, Ahmad CS, Gorroochurn P, D'Angelo J, Ciccotti MG, Dines JS, Altchek DW, Camp CL. If your bone is broken, a pin will be used to put it in place. All techniques improved clinical outcomes, including pain, motion, strength, and stability. [32], Nonsurgical treatment has been advocated for nondisplaced, or minimally displaced avulsion fractures of the UCL either with functional bracing[35] or via thumb spica casting or splinting. Therefore, these patients were included in the surgical group for analysis, as they did have more than 2 years minimum clinical follow-up after surgical treatment. government site. J Bone Joint Surg Am. Exercises: Gradually progress to competitive throwing and sports . When the thumb is straight, the collateral ligaments are tight and stabilize the joint against valgus force. Ulnar collateral ligament (UCL) rupture is often seen in patients practicing sports activities, particularly in ski falls. Potentially inclusive articles were manually reviewed, discussed among the authors, and a decision was made regarding inclusion or exclusion. PMC Jupiter JB, Sheppard JE. No study reported the outcomes of nonoperative management of chronic UCL injury. [15] In patients who had failed nonoperative treatment, who were subsequently taken to surgery, it was found that many of the small avulsion fractures had rotated with the fragment's articular surface rotated out of the plane, precluding fracture healing.[15]. The UCL has as its central function maintenance of ulnar stability of the joint, which is paramount for pinch grip. Possible complications include: - For example, it can be removed when performing . Corresponding Author: Hisham M. Awan, MD, The Ohio State University Hand and Upper Extremity Center, 915 Olentangy River Rd, Suite 3200, Columbus, OH 43212 ([emailprotected]). Selection bias was presented based on the variance in subject age, gender, hand dominance, injury chronicity, injury location, the presence or absence of bony avulsion, the presence or absence of Stener lesion, and the retrospective nature of most of the studies. The mean patient age was 37.8 years (14.0-78.1). Keywords: eCollection 2022 May. 2021 Nov 23;9(11):23259671211055428. doi: 10.1177/23259671211055428. Please confirm that you would like to log out of Medscape. 39. Skier's thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. Am J Sports Med. 38. If the latter was executed only partially, a score of 1 was assigned. Injury and Surgical Repair to the Thumb This is an injury to the ulnar collateral ligament of the metacarpo-phalangeal (MCP) joint. Complications, failures, and reoperations are rare after surgical treatment of UCL injury. 2003;8:8185. #Injury location reported only in 3 studies. At this stage, patients should be advised to wear your splint part-time. Mayo Clinic works with baseball players of all levels, from youth leagues to Major League Baseball, to enhance prevention and treatment of ulnar collateral ligament (UCL) injuries, also known as Tommy John injuries. UCL injuries occur via thumb MCP hyperabduction or hyperextension ; in contrast, RCL injuries result from a forced or sudden thumb MCP adduction moment. 31. 2000;16:345357. Most times, they won't know until they're in the surgery if the internal brace is appropriate. 1989;17:751753. Clipboard, Search History, and several other advanced features are temporarily unavailable. Positive ulnar variance is used to describe a forearm where the distal ulna is no longer in line with the distal radius, resulting in the ulnar being longer. When assessed, most patients returned to their preinjury employment. Pain Swelling Bruising A weaker pinch or problems grabbing things when you use your thumb If surgery is needed, the ligament is reconnected to the bone. important to begin moving your fingers right after surgery and keep them moving to avoid stiffness. Clinical Journal of Sport Medicine23(4):247-254, July 2013. If you're experiencing pain, bruising and swelling in your thumb after an accident such as a fall, be sure to contact your healthcare provider. Exclusion criteria were non-English studies and any study with less than 2 years mean follow-up. A secondary purpose was to compare graft choice and surgical technique for reconstruction. Abstract Objectives: Rupture of the ulnar collateral ligament (UCL) is a frequent injury of the hand. Mean study follow-up was 42.8 months. Concomitant ulnar nerve transposition was associated with a higher neuropathy rate (16.1%) compared with no handling of the ulnar nerve (3.9%). 2019 Apr;47(5):1103-1110. doi: 10.1177/0363546519831705. Diagnosis of displaced, 43. Ritting et al[30] assert that operative management of acute injuries is indicated when the thumb is without an endpoint to valgus stress testing. 2021 Apr 15;3(2):e527-e533. Moher D, Liberati A, Tetzlaff J, et al.. Careers. 8. Muscles. Any time there is something concerning you, even if it's a slight concern, always call your surgeon right away. In the event of disagreement among authors for study inclusion, the final decision was made by the senior author (HMA). Bennet Fracture. 21. The outcome of elbow ulnar collateral ligament reconstruction in overhead athletes: a systematic review. Accurate diagnosis of finger injuries can often be difficult, given the complicated soft-tissue anatomy of the hand and the diverse spectrum of injuries that can occur. No significant difference in the outcome was demonstrated between different types of autograft used for UCL reconstruction. There is currently no consensus on treatment of acute or chronic UCL injuries. The mean prevalence of postoperative ulnar neuropathy was 12.0% overall after any UCLR procedure at a mean follow-up of 3.3 years, and 0.8% of cases required reoperation to address ulnar neuropathy. 1-6 weeks: If the ligament is partially torn then a splint or cast is usually worn for six weeks and after its removal a programme of exercises is . Orthopedics. Stretching or even a rupture of the graft is also possible. The thumb joint may feel loose and unstable, making it difficult to grasp objects between the thumb and index finger. Some error has occurred while processing your request. Methods: When evaluating the relationship between ulnar and radial ligamentous injury and the presence or absence of complication, there was no significant difference, however trends were noted, X. According to the Glickel grading system, 51 excellent (80%) (joint stability not significantly different from unoperated thumb, less than 15% MP joint motion loss, no pain, no ADL limitations, and less than 15% loss of pinch strength), 11 good (17%), and 2 fair (3%) outcomes were observed. Landsman JC, Seitz WH Jr, Froimson AI, et al.. Splint immobilization of gamekeeper's thumb. Studies that duplicated patient populations from the same authors were excluded. The surgical approach associated with the highest rate of neuropathy was detachment of flexor pronator mass (FPM) (21.9%) versus muscle retraction (15.9%) and muscle splitting (3.9%). Thus, the true natural history is yet unknown. Am J Sports Med. Careers. 45. An example of the search strategy used for PubMed was ((((((ulnar[Title/Abstract]) AND collateral[Title/Abstract]) AND ligament[Title/Abstract])) OR ucl[Title/Abstract])) AND thumb[Title/Abstract]. Each abstract was manually reviewed, with potentially relevant full text of studies scrutinized for study inclusion or exclusion. When untreated, this injury may lead to decreased pinch strength, pain, instability, and. When untreated, this injury may lead to decreased pinch strength, pain, instability, and osteoarthritis. 2014 Oct;42(10):2510-6. doi: 10.1177/0363546513509051. They may even tear completely. eCollection 2021. The mechanism of UCL injury is a forced abduction or rotation and hyperextension injury of the thumb at the MP joint.32 The most common region of rupture of the UCL is at the distal insertion or in the distal aspect of the ligament, leaving the proximal stump intact.32 Ulnar collateral ligament injuries can involve injuries to the dorsal capsule, palmar plate, and adductor aponeurosis.33 Avulsion fractures of the ulnar base of the proximal phalanx occur 20% to 30% of the time.17,34 Anywhere from 14% to 64% of UCL injuries have associated Stener lesions, which occur when the adductor aponeurosis is interposed between the ruptured end of the UCL and its site of proximal phalanx attachment.32, Nonsurgical treatment has been advocated for nondisplaced, or minimally displaced avulsion fractures of the UCL either with functional bracing35 or via thumb spica casting or splinting.23,3638 Kuz et al recommend that most acute avulsion fractures of the thumb UCL be treated nonsurgically, with the exception of displaced fractures with more than 30% articular involvement or bony Stener lesions. When untreated, this injury may lead to decreased pinch strength, pain, instability, and osteoarthritis. 415 Ray C Hunt Drive, Suite 3200 Charlottesville, VA 22903 434-982-HAND (4263) Epub 2014 Oct 22. 2005;87:26322638. In this minimally invasive technique, the surgeon makes a small cut over the back of the thumb joint and examines the area around the injury for damage. The overall complication rate after primary thumb RCL and UCL repair was 13.8%. No Difference in Complications Between Elbow Ulnar Collateral Ligament Reconstruction With the Docking and Modified Jobe Techniques: A Systematic Review and Meta-analysis. Both purely ligamentous and bony avulsion injuries were included. Disclaimer. Outcomes and Return to Sport after Ulnar Collateral ligament reconstruction in adolescent baseball players. Of the 262 potentially relevant studies, 14 studies were identified for review11,15,1829 (Figure 1). 33. Early diagnosis and treatment. If the force is too strong, the ligaments can tear. The .gov means its official. abductor pollicis longus (PIN) proximal, dorsal, and radial force on the shaft fragment. This review has demonstrated excellent clinical outcomes after surgical treatment of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. 2008 Jun;36(6):1193-205. doi: 10.1177/0363546508319053. SAGE Open Med. All but 2 were level IV evidence. If the UCL is completely torn, the ruptured ligament may cause a lump inside the thumb. This injury can have many names such as "skiers thumb", "gamekeepers thumb", and "break dancers thumb.". You've successfully added to your alerts. Pichora DR, McMurtry RY, Bell MJ. Throwing status reported in 4 studies. Corresponding Author Hisham M. Awan, MD, The Ohio State University Hand and Upper Extremity Center, 915 Olentangy River Rd, Suite 3200, Columbus, OH 43212 (hisham.awan@osumc.edu). Complications after surgery were rare. Am J Sports Med. fall on outstretched hand and abducted thumb ball or racquet strike Symptoms common symptoms pain at ulnar aspect of MCP joint worse with pinch or grasp most common for UCL tear radial-sided MCP pain most common complaint for RCL tear Physical exam inspection rarely visible deformity of joint palpation The major arc of motion of the thumb MP joint is flexion and extension, although there is some abduction, adduction, and rotation. Julie Balch Samora, MD, PhD*, Joshua D. Harris, MD, Michael J. Griesser, MD, Michael E. Ruff, MD* and Hisham M. Awan, MD* *The Ohio State University Hand and Upper Extremity Center, Columbus, Ohio; Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois; and Performance Orthopaedics and Sports Medicine, Wilmington, Ohio. Rao S, D'Amore T, Willier DP 3rd, Gawel R, Jack RA 2nd, Cohen SB, Ciccotti MG. Orthop J Sports Med. A systematic review of the literature was completed using the MEDLINE, PubMed, and Ovid databases. Detection bias was present in the inconsistent use of an invalidated outcomes tool (Glickel grading system), visual measurement of range of motion, different tools for strength and stability measurement, and the subjective nature of reporting weakness and stability. Federal government websites often end in .gov or .mil. What are the symptoms of GameKeeper's Thumb? Smith RJ. Surgical techniques and a review of 70 patients. The goal of Fusion Arthroplasty of the CMC joint is to fuse the bones together in the thumb so that they do not rub on each other and cause pain. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Abstract. The https:// ensures that you are connecting to the Because patients can start moving the thumb within days, it also mitigates some of the negative consequences of prolonged immobilization, such as stiffness and muscle atrophy. Various levels of pain, bruising, or edema may present at the site of damage. Tension wire fixation of avulsion fractures in the hand. Thus, a patient with delayed presentation of UCL injury can still achieve predictably successful outcomes, equivalent to acute repair, with autograft UCL reconstruction. Infection is a rare complication of hand surgery. Meta-analysis of the pooled data was completed. All techniques improved clinical outcomes, including pain, motion, strength, and stability (Table 5). After three to four weeks, the joint should heal enough to remove the splint and begin strengthening exercises. In Memoriam: Healthcare Workers Who Have Died of COVID-19, Time to Return to Running After Tibial Stress Fracture in Female Division I Collegiate Track and Field, Sports Hernias, Adductor Injuries, and Hip Problems Are Linked. Ulnar Collateral Ligament Repair . It was hypothesized that surgical management results in equivalent outcomes for both acute and chronic UCL injury. 14. If given within individual studies, the P values calculated by the authors of the individual studies were used and not retested because of a lack of subject-level data. The doctor won't know if the repair is . This article provides a review of . Mean subject age was 33.9 years. Looney AM, Wang DX, Conroy CM, Israel JE, Bodendorfer BM, Fryar CM, Pianka MA, Fackler NP, Ciccotti MG, Chang ES. Patient Demographics of Thumb RCL and UCL Injuries. Epub 2021 Sep 7. Sakellarides HT, DeWeese JW. MCP collateral ligament sprain is most commonly an acute injury related to trauma. All authors independently performed the search. A sprained thumb is a common injury among athletes. Surgery has been recommended for fracture displacement, significant articular involvement, clinical instability, or fragment rotation. All but 2 were level IV evidence. FOIA Rupture of the ulnar collateral ligament (UCL) is a frequent injury of the hand. Keyword Highlighting better/same/worse than preoperative status). Our primary purpose was to compare nonoperative treatment with surgical repair and surgical reconstruction of thumb UCL injuries. 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. Epub 2020 Jun 29. [30,43,44] It has been well documented that direct suture techniques fail in chronic injuries. 1992;8:713732. The authors report no funding or conflicts of interest. Range of motion returns much sooner, too. Complications after surgical treatment of UCL injury are rare. When a broken bone fails to heal it is called a "nonunion." A "delayed union" is when a fracture takes longer than usual to heal. When applicable, these parameters were compared, integrated, summated, and statistically analyzed. the splint for protection or at night until twelve weeks after the operation. This tool is a 12-item instrument, with each item possibly receiving a minimum integer of 0 and a maximum integer of 2 score points. MeSH 22. This is a strong ligament that supports the thumb when pinching or gripping and if it is damaged may lead to a chronic instability of the thumb which causes problems with function. A Stener lesion is difficult to diagnose but leads to poor healing and usually indicates operative management. Julie Balch Samora, MD, PhD; Joshua D. Harris, MD; Michael J. Griesser, MD; Michael E. Ruff, MD; Hisham M. Awan, MD. Chronic post-traumatic radial instability of the metacarpophalangeal joint of the finger. Mean Quality Appraisal Tool score was 13.1 (55% overall rating study methodological quality). There is also significant performance bias, as there are multiple different methods of treatment, providers, graft, suture, and fixation types, as well as methods and duration of immobilization. Nonoperative treatment often failed, necessitating surgery. Results of surgical treatment of acute and chronic grade III [corrected] tears of the radial collateral ligament of the thumb metacarpophalangeal joint. Dr. Holt will talk to you about when it is safe to return to work. Metacarpophalangeal joint fusion was performed on 36.3% (4/11) of patients with RCL (N=1) and UCL (N=3) tears. Purpose. 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. Kuz JE, Husband JB, Tokar N, et al.. Acute UCL repair and autograft UCL reconstruction for chronic injury led to excellent clinical outcomes, without a significant difference between the 2 groups. The limitations of this systematic review are reliant on the studies analyzed. Part I of this two-part article focuses on common tendon and . A broken thumb usually causes more intense pain, and your thumb may look deformed or misshapen. J Hand Surg Glob Online. [17,34] Anywhere from 14% to 64% of UCL injuries have associated Stener lesions, which occur when the adductor aponeurosis is interposed between the ruptured end of the UCL and its site of proximal phalanx attachment. A score of 0 was assigned if the item was either omitted or not performed. Dinowitz M, Trumble T, Hanel D, et al.. Failure of cast immobilization for thumb. Thumb dominance reported in 8 studies (168 thumbs). Leland DP, Pareek A, Therrien E, Wilbur RR, Stuart MJ, Krych AJ, Levy BA, Camp CL. 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. The Orthopedic Journal of Sports Medicine. Wolters Kluwer Health, Inc. and/or its subsidiaries. Furthermore, there was no donor site morbidity from autograft harvest sites across all studies. Data collected on each patient included patient demographics, imaging (x-rays and MRI), perioperative data (e.g. Am J Sports Med. If you experience a high temperature, excess bleeding, swelling or pain, contact your surgeon. Exercises: Progress to Phase II throwing (once successfully completed Phase I) POST-OPERATIVE WEEK 30-32 . Please try after some time. 2022 Jun;54(2):191-196. doi: 10.5152/eurasianjmed.2022.22024. Federal government websites often end in .gov or .mil. Fourteen articles were included and analyzed (293 thumbs). Main results: Rupture of the ulnar collateral ligament (UCL) is a frequent injury of the hand. Thumb collateral ligament injuries. There were 6 studies that reported clinical outcomes after acute UCL repair using different techniques.20,2426,28,29 Repair techniques (Table 4) included pullout suture over button with or without Kirschner wire immobilization, suture anchors, soft tissue periosteal suture, and arthroscopic Stener reduction with K-wire. 26. Results You will be limited for the first 6 weeks with pain, weakness, and stiffness in the hand and thumb. [31] The adductor pollicis supplies active support on the ulnar aspect, whereas the abductor pollicis brevis and flexor pollicis brevis provide dynamic stability on the radial border. Furthermore, each bibliography was cross-referenced for potentially inclusive studies missed by the original search terms. The UCL is also known as the medial collateral ligament or "Tommy John Ligament".
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