Anatomical 3 Ligaments Reconstruction for Symptomatic Thumb Carpometacarpal Joint Instability

Thumb carpometacarpal (CMC) joint instability is thought to be a debilitating disorder and, if left untreated, develops joint persistent synovitis and osteoarthritis. In this study, we report a novel surgical technique reconstructing the anterior oblique ligament, the dorsoradial ligament, and the intermetacarpal ligament simultaneously using both the transverse carpal ligament, and the palmaris longus tendon. Six patients with a mean age of 44 years showing no osteoarthritic changes by the radiographical examination underwent our anatomical three ligaments reconstruction for persistent painful thumb CMC joint instability. Clinical results with the mean follow-up of 20 months demonstrated that the pain was subjectively improved in all patients, both the grip and the pinch strength were increased significantly and good functional motion of the thumb could be observed after the operation. These findings indicated that our surgical procedure could be one option of treatment of the symptomatic CMC joint instability in early-stage arthritis.