title: Bone-retinaculum-bone reconstruction for chronic posttraumatic instability of the metacarpophalangeal joint of the thumb.
abstract: OBJECTIVE
  This study presents an autograft technique for the surgical management of chronic posttraumatic instability of the thumb metacarpophalangeal (MCP) joint by using a bone-retinaculum-bone graft from the second compartment of the extensor retinaculum.
  
  
  METHODS
  The bone-retinaculum-bone graft was harvested from the second compartment. The graft ends were fixed into the host site with screws. Fourteen patients (12 ulnar, 2 radial collateral ligament tears) had the procedure. All patients were reviewed by an independent observer using objective and subjective criteria, the mean follow-up time was 20 months.
  
  
  RESULTS
  Results were satisfactory overall (8 excellent, 4 good, 1 fair, 1 poor that subsequently was fused). All patients returned to their former jobs. All but one had a clinically stable first MCP joint; grasp was 87%, pinch was 80%, MCP joint range of motion (ROM) was 91%, and interphalangeal joint ROM was 98% of the unoperated side.
  
  
  CONCLUSIONS
  Early results are encouraging. This procedure preserves ROM of the MCP and interphalangeal joints of the thumb, improves strength, and gives the stability required for proper thumb function.
authors.affiliation: Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Kamel
authors.initials: K
authors.lastname: Guelmi
authors.forename: Alain
authors.initials: A
authors.lastname: Thébaud
authors.forename: Jean Roger
authors.initials: JR
authors.lastname: Werther
authors.forename: Gilles
authors.initials: G
authors.lastname: Candelier
authors.forename: Bruno
authors.initials: B
authors.lastname: Barbato
authors.forename: Levon
authors.initials: L
authors.lastname: Doursounian
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000293:injuries / Q000503:physiopathology / Q000637:transplantation*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D013933:Thumb / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*