Highlights
- •Thumb ulnar collateral ligament reconstruction with tendon graft is a common procedure.
- •Internal brace reinforcement can increase the strength of the reconstruction.
- •Modern anchor materials allow stable fixation of the graft.
- •Swivelock anchors provide similar strength to interference screws.
Abstract
Background
Chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal joint
are often not eligible for direct surgical repair and ligament reconstruction could
be considered. Several reconstruction techniques are published, with different types
of configurations and fixation methods of the tendon grafts. However, failure of the
reconstruction with recurrent instability is still a problem, despite stable graft
to bone fixation. Augmentation of the free tendon graft with non-resorbable suture
material is gaining popularity, aiming to withstand elongation or rupture of the graft.
The purpose of this study was to compare two different augmented ulnar collateral
ligament reconstruction methods in a cadaver model.
Methods
Ten matched pairs of cadaveric upper extremities were used. The thumbs were disarticulated
at the trapezometacarpal joint and the ulnar collateral ligament was excised then
reconstructed with InternalBrace™ reinforced tendon graft, which was fixed to the bones using either a Tenodesis
screw or DX Swivelock® anchor. The thumbs were biomechanically tested with valgus
stress, while the force and displacement were simultaneously measured and plotted.
Findings
The mean (SD) load at clinical failure and maximum load were 19.4 (5.3) and 31.4 (9.5)
N in the Tenodesis group, and 21.0 (10.0) and 31.4 (13.9) N in the DX SwiveLock® group,
respectively. None of these differences were significant. These results are comparable
with previous publications.
Interpretation
The Tenodesis screw and the DX SwiveLock® thumb ulnar collateral ligament reconstruction
with InternalBrace™ reinforced free tendon graft showed equal strength, both methods are feasible
alternatives in the clinical setting.
Keywords
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Article info
Publication history
Published online: September 27, 2022
Accepted:
September 23,
2022
Received:
March 8,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
