Dorsoradial Ligament Reconstruction For Instability After Trapeziometacarpal Dislocation

Trapeziometacarpal (TMC) dislocations are rare injuries that can lead to chronic instability, pain, and early degenerative changes if not properly addressed. While multiple surgical techniques exist for stabilizing the TMC joint, there is ongoing debate regarding the optimal approach. The dorsoradial ligament (DRL) has been increasingly recognized as the primary stabilizer of the TMC joint, and its insufficiency is a key contributor to post-traumatic instability. Traditional reconstruction techniques, such as the Eaton-Littler method, often involve tendon transfers, which introduce donor site morbidity, increased operative time, and prolonged recovery. Here, we describe a novel technique for DRL reconstruction utilizing a knotless suture augmentation system, providing a minimally invasive robust stabilization without the need for tendon transfer. Dorsoradial ligament reconstruction using knotless suture augmentation offers a technically simple, efficient, and less morbid alternative to tendon-based reconstruction techniques. This method provides early robust fixation while preserving native anatomy, potentially reducing failure rates associated with dorsoradial ligament insufficiency. While early results are promising, longer-term follow-up and larger sample sizes are needed to fully validate its efficacy in preventing post-traumatic arthritis and recurrent instability.