Using Extensor Retinaculum to Reconstruct the Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Hand Surgery

Background:

• Chronic complete tears of the thumb's ulnar collateral ligament (UCL) frequently necessitate surgical intervention.
• Current surgical reconstruction methods, graft materials, and indications lack universal consensus.
• Restoring UCL integrity is crucial for thumb function, particularly pinch strength.

Purpose of the Study:

• To present a novel surgical technique for UCL reconstruction using the extensor retinaculum.
• To evaluate the efficacy of this technique in restoring thumb pinch strength.
• To highlight the advantages of using the extensor retinaculum as a graft.

Main Methods:

• A surgical reconstruction technique utilizing a slip of the extensor retinaculum for UCL repair was employed.
• The extensor retinaculum graft was chosen for its biomechanical properties and minimal donor site morbidity.
• Patient outcomes were assessed based on the restoration of thumb pinch function.

Main Results:

• The described extensor retinaculum graft successfully reconstructed the ulnar collateral ligament.
• This method demonstrated effectiveness in restoring thumb pinch strength post-surgery.
• The graft exhibited favorable characteristics, including synovial and nonsynovial surfaces and elasticity comparable to the native ligament.

Conclusions:

• Reconstruction of the thumb UCL using the extensor retinaculum is a viable and effective surgical option.
• This technique offers advantages such as matching native ligament properties and reduced donor site morbidity.
• Successful restoration of pinch function validates the utility of this innovative approach.