title: Avulsion fracture and complete rupture of the thumb radial collateral ligament.
abstract: OBJECTIVE
  Acute grade III tears of the radial collateral ligament (RCL) of the thumb as well as certain bony avulsion fractures receive early surgical repair at our institution. The aim of this study was to evaluate if patients would benefit from this treatment algorithm at long-term.
  
  
  METHODS
  47 patients with RCL bony avulsion fracture or grade III RCL tear were evaluated at a median follow-up of 4.5 years (range 1-17.3 years). Grade III RCL tears were treated operatively when presenting >30° angulation in stress X-ray together with palmar subluxation of ≥3 mm. Further, avulsed bony fragments with diastasis >2 mm or fragment rotation >30°-45° in conventional X-ray underwent surgery. 6 patients with grade III RCL tear as well as 9 patients with bony avulsion underwent surgical repair.
  
  
  RESULTS
  At follow-up, metacarpophalangeal joint stability and pain free ROM did not differ significantly between the groups. Subjective satisfaction based on the Catalano grading system revealed excellent results in operatively and conservatively treated patients.
  
  
  CONCLUSIONS
  This retrospective analysis indicates that early surgical repair in severe RCL injuries is associated with unrestricted ROM, persistent joint stability, and subjective patient satisfaction. This data suggest that surgical treatment in certain RCL injuries might be a feasible therapeutic option in order to avoid chronic instability.
authors: Department of Trauma Surgery, General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria. juliakoettstorfer@yahoo.de
authors: J
authors: J
authors: Köttstorfer
authors: M
authors: M
authors: Hofbauer
authors: I
authors: I
authors: Krusche-Mandl
authors: G
authors: G
authors: Kaiser
authors: J
authors: J
authors: Erhart
authors: P
authors: P
authors: Platzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D017885:Collateral Ligaments / Q000293:injuries* / Q000601:surgery*; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012421:Rupture; D013933:Thumb / Q000000981:diagnostic imaging / Q000293:injuries*; D055815:Young Adult