Easy tensioning of two-limb ligament reconstructions with docking fixation

Isometric ligament reconstruction with two graft limbs is used for chronic ligament injuries. Our technique facilitates proper tensioning. It is described in thumb metacarpophalangeal joint ulnar collateral ligament reconstruction. After passing through a tunnel in the base of the phalanx, the two limbs of the graft are docked inside the metacarpal socket. The graft is then fixed under continuous manual tensioning using a Pushlock® anchor. This technique is easy and reproducible; introduction inside the tunnel does not compromise the graft and tensioning is under continuous control. This technique is applicable to any hand, wrist, or elbow ligament reconstruction.