Bone-retinaculum-bone reconstruction for chronic posttraumatic instability of the metacarpophalangeal joint of the thumb.
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.
Guelmi
Kamel
K
Hôpital Européen Georges Pompidou, Paris, France.
Thébaud
Alain
A
Werther
Jean Roger
JR
Candelier
Gilles
G
Barbato
Bruno
B
Doursounian
Levon
L
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*