Bone-periosteum-bone graft reconstruction for chronic ulnar instability of the metacarpophalangeal joint of the thumb--minimum 5-year follow-up evaluation.
OBJECTIVE
The present study evaluated prospectively the functional and radiological results of a consecutive series of 7 patients who had bone-periosteum-bone (BPB) grafts harvested from the iliac crest for treatment of chronic ulnar instability of the metacarpophalangeal (MCP) joint of the thumb after a minimum of 60 months.


METHODS
Seven thumbs from 7 patients were entered into a prospective study for surgical treatment of chronic finger joint instability. Treatment consisted of reconstruction of the ulnar collateral ligament of the MCP joint of the thumb by a BPB graft harvested from the iliac crest. Stability, range of motion, pinch grip, and radiographs were evaluated at least 60 months after surgery.


RESULTS
All 7 patients had full active range of motion of the treated thumb at the final follow-up evaluation (average, 75 months after surgery). All patients had equal stability and normal pinch grip when comparing with the untreated thumb. The mean time off work was 3 months for 6 patients who were injured at work. At final follow-up evaluation, radiographs showed all grafts incorporated without implant complications, no osteoarthritis changes were noted, and stress radiographs showed that all patients had normal stability in the treated thumb when compared with the untreated thumb.


CONCLUSIONS
Chronic ulnar instability of the MCP joint of the thumb reconstructed with BPB graft harvested from the iliac crest is an effective and safe method to allow restoration and maintenance of a stable, pain-free thumb. The results of the current study support the long-term durability of this method.


METHODS
Therapeutic IV.
Wong
Tak-Chuen
TC
Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China. tedwong2@i-cable.com
Ip
Fu-Keung
FK
Wu
Wing-Cheung
WC
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010521:Periosteum / Q000637:transplantation*; D052581:Pinch Strength; D011446:Prospective Studies; D016059:Range of Motion, Articular; D018582:Sick Leave / Q000706:statistics & numerical data; D013933:Thumb / Q000601:surgery*