Repair of the Thumb Ulnar Collateral Ligament With Suture Tape Augmentation

We describe the surgical technique of suture tape augmentation for thumb UCL repair. At the ulnar aspect of the thumb MCP joint, a longitudinal midaxial incision is made. Subsequently, the adductor pollicis aponeurosis and extensor mechanism are identified, incised, and retracted. The UCL is exposed and usually torn off the volar-ulnar base of the proximal phalanx. A 2.5-mm PushLock anchor loaded with 1.3-mm SutureTape and 3-0 FiberWire suture, is placed into a hole at the volar-ulnar base of the proximal phalanx after preparation with a 1.8-mm drill bit. The 3-0 FiberWire is used for direct repair of the ligament. Both tails of the 1.3-mm SutureTape is then brought proximally over the ligament and loaded into a 3.5-mm SwiveLock anchor. A 3.2-mm drill bit is then used to make a hole at the ulnar aspect of the metacarpal head, just proximal to the attachment of the proximal UCL. With the thumb MCP joint held in at least 30 degrees of flexion, the tape-loaded 3.5-mm SwiveLock anchor is inserted into metacarpal head. Reinforcement of the repair is then carried out with fine absorbable suture to surrounding capsular tissue. We present a representative case of a professional basketball player treated with this novel procedure. After the surgical repair, the patient was placed in a plaster splint for 3 days to immobilize the thumb and wrist. At 3 days postsurgery, the splint was removed and therapy initiated. Practice drills were initiated at 1 week postsurgery with the use of a re...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research