Synthetic Tape Augmentation for Thumb Carpometacarpal Joint Instability: Surgical Technique

Background  Dorsal thumb carpometacarpal (CMC) instability can occur after traumatic injury and can lead to persistent pain and dysfunction of the hand. We present a case report of a joint-sparing technique for recurrent thumb CMC instability after failed Eaton-Littler procedure. Case Description  We describe a technique to repair the dorsal radial ligament and augment the repair with dorsal synthetic tape. To illustrate this technique, we describe a patient who underwent the synthetic tape augmentation procedure for recurrent thumb CMC instability after a failed Eaton-Littler reconstruction. Preoperative and postoperative grip strength, appositional pinch, oppositional pinch, radial abduction, palmar abduction, and postoperative quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) were recorded. At final follow-up 18 months after surgery, the patient had returned to manual work without any functional sequelae. The thumb CMC joint was stable and his postoperative QuickDASH score was 15.9. Literature Review  Thumb CMC instability has traditionally been treated with Eaton-Littler ligament reconstruction which uses a slip of flexor carpi radialis tendon to reconstruct the deficient ligaments. More recently, the importance of the dorsal radial ligament in joint stability has been recognized and new procedures have been described to reconstruct the dorsal radial ligament. To our knowledge, synthetic tape augmentation for thumb CMC instability has not yet been described for this pathology. Clinical Relevance  Synthetic tape augmentation for dorsal thumb CMC instability may be considered in the management of dorsal thumb CMC joint instability.