Breek JC, Tan AM, van Thiel TP, et al.. Free tendon grafting to repair the metacarpophalangeal joint of the thumb. Nonoperative treatment led to high patient satisfaction for acute thumb UCL injury in 2 studies.23,29 Thirty-two subjects were treated with thumb-spica immobilization (30 were proximal phalanx avulsion fractures). 2014 Dec;33(6):384-9. doi: 10.1016/j.main.2014.10.003. It is an often-encountered injury and can lead to chronic pain and instability when diagnosed incorrectly. All continuous data for independent and dependent variables were assimilated with weighted means and SDs based on the number of subjects or thumbs and the applicable means and SDs. 2. The outcome of elbow ulnar collateral ligament reconstruction in overhead athletes: a systematic review. Ford GM, Genuario J, Kinkartz J, Githens T, Noonan T. Am J Sports Med. The .gov means its official. Get new journal Tables of Contents sent right to your email inbox, Outcomes After Injury to the Thumb Ulnar Collateral LigamentA Systematic Review, Articles in PubMed by Julie Balch Samora, MD, PhD, Articles in Google Scholar by Julie Balch Samora, MD, PhD, Other articles in this journal by Julie Balch Samora, MD, PhD, Ulnar Collateral Ligament Injury of the Thumb Metacarpophalangeal Joint, Weight Training in Youth-Growth, Maturation, and Safety: An Evidence-Based Review, Effectiveness of Shockwave Treatment Combined With Eccentric Training for Patellar Tendinopathy: A Double-Blinded Randomized Study, Core Stability Exercises for Low Back Pain in Athletes: A Systematic Review of the Literature, Diagnosis and Treatment of Triceps Tendon Injuries: A Review of the Literature, Privacy Policy (Updated December 15, 2022). Causes. Eurasian J Med. This is a strong ligament that supports the thumb when pinching or gripping and if it is damaged may lead to a chronic instability of the thumb which causes problems with function. Infection is a rare complication of hand surgery. Accessibility At this stage, patients should be advised to wear your splint part-time. Louis DS, Huebner JJ Jr, Hankin FM. Our primary purpose was to compare nonoperative treatment with surgical repair and surgical reconstruction of thumb UCL injuries. Usually it is pulled off of the bone (proximal phalanx) on the nail side of the joint. A broken thumb can also cause numbness or tingling. Surgical Repair of Ulnar Collateral Ligament of ThumbDr. Patel SS, Hachadorian M, Gordon A, Nydick J, Garcia M. J Hand Microsurg. No study directly compared the clinical outcome between repair and reconstruction of the thumb UCL for acute (less than 3 weeks) or chronic UCL injury. Ulnar neuropathy was defined as any symptoms or objective sensory and/or motor deficit (s) after surgery, including resolved transient symptoms. [33,45] When repair is attempted, nonanatomical repositioning of the UCL may contribute to the loss of joint motion.[46]. Fourteen articles were included and analyzed (293 thumbs). Thus, a patient with delayed presentation of UCL injury can still achieve predictably successful outcomes, equivalent to acute repair, with autograft UCL reconstruction. Patients who fail nonoperative management have persistent thumb pain, decreased pinch strength, decreased grip strength, limited activities of daily living (especially opening jars and turning keys), continued instability, and early arthrosis. 2013Lippincott Williams & Wilkins. ||Injury chronicity not always defined, but we used ,3 weeks for acute injury and .3 weeks for chronic injury. Abrahamsson SO, Sollerman C, Lundborg G, et al.. All rights reserved. This review has demonstrated excellent clinical outcomes after surgical treatment of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. and transmitted securely. Alejandro Badia Orthopedic Hand Surgeon Hands, Elbow, Shoulder and Wrist - Badia Hand to Shoulder Ce. J Hand Surg Br. Metacarpophalangeal joint motion ranged from 79% to 100% compared with the contralateral thumb. Bean CH, Tencer AF, Trumble TE. I had a UCL injury (incomplete, didn't require surgery) with a small avulsion fracture to my right thumb in 2015 at the age of 36. Clinical Journal of Sport Medicine23(4):247-254, July 2013. You may also begin strengthening exercises if needed. A blunt self-retainer is used to retract the musculature, and a small periosteal elevator can be used to clean any remaining muscle fibers from the UCL. Complications after surgical treatment of UCL injury are rare. 2022 Jun;54(2):191-196. doi: 10.5152/eurasianjmed.2022.22024. There were 6 studies that reported clinical outcomes after acute UCL repair using different techniques.20,2426,28,29 Repair techniques (Table 4) included pullout suture over button with or without Kirschner wire immobilization, suture anchors, soft tissue periosteal suture, and arthroscopic Stener reduction with K-wire. and transmitted securely. Our primary purpose was to compare nonoperative treatment with surgical repair and surgical reconstruction of thumb UCL injuries. Wolters Kluwer Health, Inc. and/or its subsidiaries. [6] Treatment [ edit] A post-operative photo of repair of a complete rupture of the ulnar collateral ligament. Subject demographics are reported in Table 2. Conflicts of interest The authors report no funding or conflicts of interest. 415 Ray C Hunt Drive, Suite 3200 Charlottesville, VA 22903 434-982-HAND (4263) Significantly better motion and strength and fewer complications were observed with suture anchors and early mobilization versus suture button and cast immobilization (P < 0.05).20 Only 3 patients in these 6 studies had residual laxity. There was no significant difference in patient-specific and injury-specific parameters (subject age, gender, hand dominance, time to treatment, or length of follow-up) between patients with successful and failed nonsurgical treatment (P > 0.05 for each of the compared independent and dependent variables). Conclusions: 2014 Oct;42(10):2510-6. doi: 10.1177/0363546513509051. Would you like email updates of new search results? 21. To address the purposes of this systematic review, the authors conducted a search of the following medical databases: PubMed, SPORTDiscus, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Cochrane Central Register of Controlled Trials. abductor pollicis longus (PIN) proximal, dorsal, and radial force on the shaft fragment. After significant delay to treatment or even failed nonoperative treatment, excellent clinical outcomes can be achieved, without a difference between initially treating the injury surgically. 1999;24:275282. A score of 0 was assigned if the item was either omitted or not performed. Sixty nine (86.3%) patients had grade 3 tears. Further detection bias existed in that not all studies used each clinical outcome (eg, Glickel grade) or radiographic measure postoperatively. Bookshelf Through a small incision along the side of the thumb joint, we will see where the ligament was torn. Bostock S, Morris MA. government site. Objectives: A Bennet fracture is an intra-articular fracture of the 1st metacarpal fracture caused by an axial force applied to the thumb in flexion, that requires surgical fixation when displaced. Please try again soon. This damage may lead to temporary or permanent numbness or weakness. 23. The ECRL bone-tendon ligamentoplasty for chronic ulnar instability of the metacarpophalangeal joint of the thumb. This systematic review has demonstrated excellent clinical outcomes (pain, strength, motion, and stability) after surgical treatment (repair and autograft reconstruction) of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. 38. Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. In addition, operative management was hypothesized to result in greater patient satisfaction versus nonoperative treatment. Methodological quality of the study was assessed using the Quality Appraisal Tool (Table 1). Injuries to the PIP joint remain swollen for long periods of time. The site is secure. Skier's thumb is a partial or complete rupture of the ulnar collateral ligament of the metacarpophalangeal joint of the thumb. Instruct the patient to begin active range of motion exercises of the thumb without stressing the UCL/RCL repair. Complications after surgery were rare. Arthritis Rheum. *The Ohio State University Hand and Upper Extremity Center, Columbus, Ohio; Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois; and. Careers. Possible complications include: - All techniques improved clinical outcomes, including pain, motion, strength, and stability (Table 5). Leland DP, Pareek A, Therrien E, Wilbur RR, Stuart MJ, Krych AJ, Levy BA, Camp CL. If any instability of the metacarpo-phalangeal joint is detected on the radial side of the joint with lateral stress and ulnar deviation than repair or reconstruction of the radial . 44. eCollection 2021 Nov. Yu JS, Carr JB 2nd, Thomas J, Kostas J, Wang Z, Khilnani T, Liu K, Dines JS. Jupiter JB, Sheppard JE. Epub 2014 Oct 22. J Hand Surg Am. Smith RJ. 32. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart search algorithm with PubMed database. Orthop Rev. Looney AM, Wang DX, Conroy CM, Israel JE, Bodendorfer BM, Fryar CM, Pianka MA, Fackler NP, Ciccotti MG, Chang ES. 14 It is important to diagnose complete tears early because . 1999;24:7075. Am J Orthop (Belle Mead NJ). UCL repair surgery is a procedure to treat an injury to the UCL, the soft tissue that connects the bones of the thumb and provides stability to the thumb joint. abduction-adduction motion. The surgical approach associated with the highest rate of neuropathy was detachment of flexor pronator mass (FPM) (21.9%) versus muscle retraction (15.9%) and muscle splitting (3.9%). Orthop Clin North Am. [15,39] It is not entirely clear why patients fail nonoperative treatment, but some authors contend that failure may be because of irreducible displacement of the ruptured ligament. Early and late postoperative complications were recorded. 1989;17:751753. Am J Sports Med. Bethesda, MD 20894, Web Policies Surgical management of chronic, 42. This site needs JavaScript to work properly. If you experience a high temperature, excess bleeding, swelling or pain, contact your surgeon. Ulnar Collateral Ligament Repair . Modified Jobe Versus Docking Technique for Elbow Ulnar Collateral Ligament Reconstruction: A Systematic Review and Meta-analysis of Clinical Outcomes. In addition, basic science, anatomical/histopathological, imaging, biomechanical, surgical technique, and studies on digits other than the thumb were excluded. Stener B. Skeletal injuries associated with rupture of the. Epub 2013 Nov 12. doi: 10.1097/JSA.0000000000000322. Acute UCL repair and autograft UCL reconstruction for chronic injury led to excellent clinical outcomes, without a significant difference between the 2 groups. The limitations of this systematic review are reliant on the studies analyzed. Gamekeeper's thumb. Outcome of avulsion fractures of the ulnar base of the proximal phalanx of the thumb treated nonsurgically. MeSH eCollection 2021 Oct. Rashidi A, Haj-Mirzaian A, Dalili D, Fritz B, Fritz J. Eur Radiol. Triangular fibrocartilage complex injury is one of the most common causes of ulnar wrist pain and can impair daily activities, such as door opening and handshaking. The mean time from reported injury date to surgery was 202.4 days (2-5969). If your bone is broken, a pin will be used to put it in place. 2012 Nov 7;94(21):2005-12. doi: 10.2106/JBJS.K.01024. The search was performed on November 17, 2011, using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.13 There were no limits placed on study publication date. Mean Quality Appraisal Tool score was 13.1 (55% overall rating study methodological quality). 26. Studies that duplicated patient populations from the same authors were excluded. Mechanism of injury to the RCL of the MCP joint of the thumb is force . 2005;87:26322638. Return-to-Play Rates and Clinical Outcomes of Baseball Players After Concomitant Ulnar Collateral Ligament Reconstruction and Selective Ulnar Nerve Transposition. Surgery has been recommended for fracture displacement, significant articular involvement, clinical instability, or fragment rotation. to maintaining your privacy and will not share your personal information without
Exercises: Gradually progress to competitive throwing and sports . Gamekeepers thumb: a prospective study of functional bracing. The Orthopedic Journal of Sports Medicine. After application of all inclusion and exclusion criteria, 14 studies were identified for further analysis and review. Before Pain, range of motion, key-pinch strength, and stability testing were used as outcome measures. Mean study follow-up was 42.8 months. Am J Sports Med. [16] Despite these study limitations, this systematic review is strong in that it analyzes the largest number of studies and subjects in the literature managed with both nonoperative and operative means for acute and chronic UCL injury. Furthermore, each bibliography was cross-referenced for potentially inclusive studies missed by the original search terms. Most patients have minimal pain by 6 weeks after surgery, with nearly full thumb and hand motion by 3 months. The rate of complications after RCL primary repair was higher than UCL repair, however not statistically significant. For this elbow surgery, the internal brace is most appropriate for the athlete that has a UCL sprain that is not complex. Ulnar collateral ligament injuries of the thumb (gamekeeper or skier thumb) are more common than the radial side but both can cause significant disability. Comparison of Outcomes Based on Graft Type and Tunnel Configuration for Primary Ulnar Collateral Ligament Reconstruction in Professional Baseball Pitchers. This was a retrospective study of all patients seen and treated for thumb injuries at a single institution from January 1, 2015, to December 31, 2019, undergoing RCL or UCL repair (CPT code 26540). Data is temporarily unavailable. 2019 Apr;47(5):1103-1110. doi: 10.1177/0363546519831705. J Hand Surg Glob Online. three muscles provide deforming forces at the base of the thumb. Thus, the latter group of patients (n = 93) was reported separately as chronically UCL-deficient operatively treated subjects' outcomes (Table 3) with attempted prior nonoperative treatment. An official website of the United States government. Post-traumatic instability of the metacarpophalangeal joint of the thumb. Mean Quality Appraisal Tool score was 13.1 3.5 (range, 819), which correlated with a 54.6% 14.5% quality rating. Katolik LI, Friedrich J, Trumble TE, et al.. Repair of acute. There are many ways to manage both acute and chronic thumb UCL deficiency, and controversy persists as to the best treatment options. Educate the patient on anti edema management. The major arc of motion of the thumb MP joint is flexion and extension, although there is some abduction, adduction, and rotation. Meta-analysis of the pooled data was completed. Downey DJ, Moneim MS, Omer GE Jr. Thorough literature review to define the question, Specific inclusion and exclusion criteria, Appropriate scope of psychometric properties, Sample size calculation and justification, Authors referenced specific procedures for administration, scoring, and interpretation of procedures, Valid conclusions and clinical recommendations, 96% good and excellent outcomes* with stable joint, pain relief, restored strength, and 85% motion retention, 100% good and excellent outcomes,* 85% without pain, 70% without laxity, 82% strength retention, and 79% motion retention, 100% good and excellent outcomes,* 100% without pain or instability, 89% strength retention, and 90% motion retention, 100% stability, 96% key pinch strength retention, and 106% pulp pinch strength retention, 89% without pain, 89% pinch strength retention, 93% grip strength retention, and 74% motion retention, 100% good and excellent outcomes,* 90% strength retention, and 92% motion retention, 100% stability, 100% strength retention, and 100% motion retention, Both returned to previous level of sport and function, Compared intraosseous suture anchor and early mobilization to pullout suture or button and cast immobilization, Both groups significantly improved outcomes, 9 had suture periosteal repair; 1 had pullout suture repair, 31% loss of motion at MP joint; 10% loss of motion at IP joint, Arthroscopic Stener reduction and K-wire MP immobilization, No patient had loss of motion .10 degrees, 8 ligament repairs; 1 anchor; 1 drill hole; 4 K-wire fixations of avulsion, No detectable residual UCL laxity in 10 patients, 2 had less than 15 degrees laxity, 7 pullout suture and K-wire MP immobilization; 25 periosteal soft tissue suture, Palmaris longus via bone tunnels with or without K-wire fixation MP joint, Iliac crest boneperiosteumbone with cortical screw fixation, ECRL bonetendon ligamentoplasty with 1.5-mm titanium screw and suture anchor fixation, Palmaris longus via bone tunnels with K- ire fixation MP joint, 20 excellent, 4 good, and 2 fair results*. *Glickel grading scale. This article provides a review of . MCP fusion was performed on 36.3% (4/11) of patients with RCL (N=1) and UCL (N=3) tears. Part I of this two-part article focuses on common tendon and . J Bone Joint Surg Am. Ulnar neuropathy was defined as any symptoms or objective sensory and/or motor deficit(s) after surgery, including resolved transient symptoms. Rupture of the. and twist using your thumb. Furthermore, the lack of patient-specific data precluded advanced statistical calculations, and weighted means from individual studies were the basis for comparison. Unilateral injuries: 291 and bilateral injury: 1. Morphometric Evaluation of Collateral Ligaments of the First Metacarpophalangeal Joint. eCollection 2021 Mar. FOIA [32], Nonsurgical treatment has been advocated for nondisplaced, or minimally displaced avulsion fractures of the UCL either with functional bracing[35] or via thumb spica casting or splinting. Only prospective studies can determine this injury course. Epub 2014 Dec 30. Highlight selected keywords in the article text. When untreated, this injury may lead to decreased pinch strength, pain, instability, and. Chronic post-traumatic radial instability of the metacarpophalangeal joint of the finger. Data sources: Rao S, D'Amore T, Willier DP 3rd, Gawel R, Jack RA 2nd, Cohen SB, Ciccotti MG. Orthop J Sports Med. 1976;58:106112. 1998;23:503506. Figure 46-1 Muscle-splitting incision through fascia to expose the ulnar collateral ligament. Thumb sprain may cause bruising, tenderness, and swelling around the base of the thumb. 1977;59:1421. [19] Although most surgical undertakings result in good clinical and functional outcomes, there are postoperative complications, including stiffness and decreased range of motion (specifically, restricted flexion at the MP joint), failed reconstruction, infection, neuropraxia, continued pain, implant failure, graft failure, loosening, scarring, and arthrosis. Ulnar collateral ligament (UCL) injuries of the elbow are a common source of pain and disability in the overhead athlete and more particularly, baseball pitchers. Gamekeeper's thumb: a quantitative evaluation of acute surgical repair. Sports Med Arthrosc Rev. Ritting et al30 assert that operative management of acute injuries is indicated when the thumb is without an endpoint to valgus stress testing. If the tear is diagnosed later a ligament reconstruction might be a better option. Conclusion: In general, be guided by symptoms and if an activity hurts, it is probably best avoided. You've successfully added to your alerts. A p-value of 0.05 was considered statistically significant. Search performed on November 17, 2011. Clin Orthop Relat Res. Julie Balch Samora, MD, PhD; Joshua D. Harris, MD; Michael J. Griesser, MD; Michael E. Ruff, MD; Hisham M. Awan, MD. Abstract. This systematic review has demonstrated excellent clinical outcomes (pain, strength, motion, and stability) after surgical treatment (repair and autograft reconstruction) of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. This includes, but not limited to, self-retrograde massage, cold therapy, and extremity elevation. 1989;14:567573. This ligament prevents the thumb from pointing too far away from the hand. J Bone Joint Surg Am. There is also significant performance bias, as there are multiple different methods of treatment, providers, graft, suture, and fixation types, as well as methods and duration of immobilization. Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament: Early Outcomes of Suture Anchor Repair with Suture Tape Augmentation. Both repair and reconstruction (autograft and allograft) techniques were inclusive. J Hand Surg Am. When untreated, this injury may lead to decreased pinch strength, pain, instability, and osteoarthritis. This is the first study to compare complication rates between radial and ulnar collateral ligament injuries of the thumb. Thumb collateral ligament injuries. J Bone Joint Surg Am. Please use this form to submit your questions or comments on how to make this article more useful to clinicians. Please enter a Recipient Address and/or check the Send me a copy checkbox. Simmons underwent surgery, also performed by Shin, to repair a torn UCL in his left thumb (like Trout, Simmons injured his non-dominant thumb). government site. Wong TC, Ip FK, Wu WC. The fixation technique associated with the highest rate of neuropathy was the modified Jobe (16.9%) versus DANE TJ (9.1%), figure-of-8 (9.0%), interference screw (5.0%), docking technique (3.3%), hybrid suture anchor-bone tunnel (2.9%), and modified docking (2.5%). No study directly compared the different types of graft for UCL reconstruction. Treatment of chronic injuries of the. 1 An injury to the ulnar collateral ligament occurs when this structure is stretched too far. Hand Clin. 16. Furthermore, it is interesting that our study quality results using the Quality Appraisal Tool were as low as they were (mean 54% with a range of 33%-79%). Kato H, Minami A, Takahara M, et al.. Surgical repair of acute collateral ligament injuries in digits with the Mitek bone suture anchor. A broken thumb usually causes more intense pain, and your thumb may look deformed or misshapen. Mean study follow-up was 42.8 months. A Novel Surgical Reconstruction Technique in the Management of Chronic Ulnar Collateral Ligament Tears with Volar Subluxation. 12. J Hand Surg Am. Federal government websites often end in .gov or .mil. In addition, this study examined how the rate of ulnar nerve complications varied as a function of surgical exposures, graft fixation techniques, and ulnar nerve management strategies. HHS Vulnerability Disclosure, Help Background: 33. 2003;8:8185. [17,34] Anywhere from 14% to 64% of UCL injuries have associated Stener lesions, which occur when the adductor aponeurosis is interposed between the ruptured end of the UCL and its site of proximal phalanx attachment. Your ligament may need to be reattached to the bone using a bone anchor. Ulnar collateral ligament injuries of the thumb: a comprehensive review. Eighty patients were included in the study [N=62 (UCL), N=18 (RCL)]. Reconstruction of the collateral ligaments using the extensor pollicis brevis tendon. Riederer S, Nagy L, Buchler U. NR, not reported. Only 1 study reported significant loss of either MP and interphalangeal joint motion (P < 0.005).25 Except for 2 patients with significant postoperative weakness, full or near-full strength (key pinch and grip) was restored in all studies. Am J Sports Med. Further detection bias existed in that not all studies used each clinical outcome (eg, Glickel grade) or radiographic measure postoperatively. The major arc of motion of the thumb MP joint is flexion and extension, although there is some abduction, adduction, and rotation.30 The stability of the MP joint derives from joint congruity, the true and accessory collateral ligaments, the volar plate, and the surrounding intrinsic muscles.31 The adductor pollicis supplies active support on the ulnar aspect, whereas the abductor pollicis brevis and flexor pollicis brevis provide dynamic stability on the radial border. Here's Advice, Emergency Birth on a Plane: Two Doctors Earn Their Wings, Brachial Plexus Injury in Sports Medicine, Cervical Spine Acute Bony Injuries in Sports Medicine. 19. He too had the internal brace augmentation. The triangular fibrocartilage complex (TFCC) is an important stabilizer of the distal radioulnar joint (DRUJ). Your surgeon is the person best able to help you avoid any serious recovery problems. It essentially forms a soft-tissue sling that keeps the radial head in place on the humerus. official website and that any information you provide is encrypted eCollection 2022 May. Detection bias was present in the inconsistent use of an invalidated outcomes tool (Glickel grading system), visual measurement of range of motion, different tools for strength and stability measurement, and the subjective nature of reporting weakness and stability. If the force is too strong, the ligaments can tear. Obremskey W, Pappas N, Attallah-Wasif E, et al.. Levels of evidence in Orthopaedic Journals. 27. Mean subject age was 33.9 years. 14. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The https:// ensures that you are connecting to the [30] The stability of the MP joint derives from joint congruity, the true and accessory collateral ligaments, the volar plate, and the surrounding intrinsic muscles. 1996;25:527530. Benson LS, Bailie DS. Fourteen articles were included and analyzed (293 thumbs). Rupture and displacement of the. UCLR case series that contained complications data were included. 2016 Mar;44(3):723-8. doi: 10.1177/0363546515621756. flexion-extension motion. J Bone Joint Surg Am. There were 6 studies that reported clinical outcomes after autograft UCL reconstruction.11,18,19,21,22,27 Reconstruction techniques (Table 5) and grafts included palmaris longus via bone tunnels with or without K-wire MP joint fixation, palmaris longus with suture anchor fixation, iliac crest boneperiosteumbone graft with cortical screw fixation, and extensor carpi radialis longus bonetendon ligamentoplasty with titanium screw and suture anchor fixation. Although the natural history of chronically untreated UCL injury eventually leads to pain and loss of function, surgery intervened in the studies present. Therefore, these patients were included in the surgical group for analysis, as they did have more than 2 years minimum clinical follow-up after surgical treatment. The diagnosis is best established clinically, though MRI is the imaging modality of choice. Complications, failures, and reoperations are rare after surgical treatment of UCL injury. 15 -17,19 Therefore, UCL reconstruction has become a common procedure to address UCL insufficiency in adolescent, collegiate, and professional throwers. 2021 Nov 23;9(11):23259671211055428. doi: 10.1177/23259671211055428. Furthermore, the lack of patient-specific data precluded advanced statistical calculations, and weighted means from individual studies were the basis for comparison. Acute rupture of the ulnar collateral ligament (UCL) of the thumb - also known as 'skier's thumb' - is a common injury which may cause long-term complications if inadequately treated. Pain, range of motion, key-pinch strength, and stability testing were used as outcome measures. unstable when the thumb is used. 2020 Apr 28;13(4):228-231. doi: 10.1055/s-0040-1709098. 2022 Mar 1;30(1):e1-e8. Thumb from the common mechanism of falling on the thumb while holding a ski pole. This systematic review has demonstrated excellent clinical outcomes (pain, strength, motion, and stability) after surgical treatment (repair and autograft reconstruction) of both acute and chronic UCL injury, without any significant difference between repair and reconstruction for acute and chronic injury, respectively. The mechanism of UCL injury is a forced abduction or rotation and hyperextension injury of the thumb at the MP joint. better/same/worse than preoperative status). Upper extremity injuries in snow skiers. HHS Vulnerability Disclosure, Help Landsman JC, Seitz WH Jr, Froimson AI, et al.. Splint immobilization of gamekeeper's thumb. This website also contains material copyrighted by 3rd parties. It is attached on one side to the humerus (the bone of the upper arm) and on the other side to the ulna (a bone in the forearm). No study directly compared nonoperative to operative treatment. You may search for similar articles that contain these same keywords or you may
Metacarpophalangeal joint instability was either not observed or mild (up to 9 degrees). I was able to work while wearing the splint. Julie Balch Samora, MD, PhD*, Joshua D. Harris, MD, Michael J. Griesser, MD, Michael E. Ruff, MD* and Hisham M. Awan, MD* *The Ohio State University Hand and Upper Extremity Center, Columbus, Ohio; Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois; and Performance Orthopaedics and Sports Medicine, Wilmington, Ohio. There were 200 acute injuries and 93 chronic injuries. Nonoperative treatment of acute UCL injury (with or without a Stener lesion) frequently fails, leading to chronic pain, instability, and weakness, eventually prompting surgical intervention. 18. 36. Posner MA, Retaillaud JL. Descriptive statistics were calculated. The mean prevalence of postoperative ulnar neuropathy was 12.0% overall after any UCLR procedure at a mean follow-up of 3.3 years, and 0.8% of cases required reoperation to address ulnar neuropathy.
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