Delayed anatomical repair of ruptured ulnar collateral ligament injuries of the thumb using a dissolvable polylactic acid bone anchor.
BACKGROUND
We describe late anatomic repair of complete distal ulnar collateral ligament (UCL) avulsions of the thumb in the absence of metacarpophalangeal joint arthritis using a dissolvable polylactic acid (PLA) bone anchor in two cases, one of which had a Stener lesion.


METHODS
Patients presented for surgery respectively at 5 months and 2 years after injury. Preoperative X-ray films showed subtle volar subluxation of the proximal phalanx. Volar plate release corrected this in both cases and a transarticular k-wire was not used. Satisfactory repair was achieved in both cases using a dissolvable PLA bone anchor. Flexion-extension mobilization was supervised by a hand therapist from day 1 after surgery. A low profile radial-sided thermoplastic splint to prevent reinjury of the UCL repair was used allowing interphalangeal joint and base of thumb movement, and was worn between therapy sessions for 4 weeks.


RESULTS
In both patients, satisfactory UCL stability was maintained at 3-year follow-up after surgery.


CONCLUSIONS
Dissolvable PLA bone anchors may be used to satisfactorily restore stability and function in late presenting complete distal UCL avulsions of the thumb with or without accompanying Stener lesions.
Pai
Sunil
S
Centre for Upper Limb Surgery, Wrightington Hospital, Wigan, United Kingdom. sunilkumarpai@doctors.org.uk
Smit
Adriaan
A
Birch
Ann
A
Hayton
Michael
M
D020341:Absorbable Implants; D000328:Adult; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000293:injuries*; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D019344:Lactic Acid; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011091:Polyesters; D011108:Polymers; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000534:rehabilitation; D011859:Radiography; D013165:Splints; D053441:Suture Anchors; D013933:Thumb / Q000293:injuries*
D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)