Thumb Ulnar Collateral Ligament Repair Using Suture Anchors and Suture Tape Augmentation

Injury to the ulnar collateral ligament of the thumb metacarpophalangeal joint is commonly encountered in clinical practice, particularly among athletes. Although repair using suture anchors is currently the gold standard, recent evidence suggests suture tape augmentation offers superior initial construct strength, allowing for earlier mobilization. This technical note describes a reproducible technique for thumb ulnar collateral ligament repair using suture tape augmentation. The procedure involves primary repair with a 1.3-mm Suturetape (Arthrex, Naples, FL) followed by internal bracing using FiberTape (Arthrex) secured with dual 3.5-mm SwiveLock anchors (Arthrex) spanning the joint. The metacarpophalangeal joint is positioned at 30° of flexion during repair to achieve optimal tension. Suture tape augmentation provides significantly higher maximum load and load at clinical failure than repair alone, with improved resistance to gap formation under cyclic loading. This enhanced construct allows for accelerated rehabilitation protocols with potentially faster return to sport and work activities in 5 to 6 weeks. The technique preserves native ligament proprioception while providing additional stability during early healing phases.