Suture-Button Stabilisation for Thumb Carpometacarpal Joint Instability and Dislocation: A Retrospective Case Series

Area of Science:

• Orthopedic surgery
• Hand surgery
• Biomaterials in medicine

Background:

• Suture-button suspension is a common technique for stabilizing the first metacarpal base after trapeziectomy.
• It is increasingly used for carpometacarpal (CMC) 1 instability, offering an alternative to traditional methods that require tendon harvest.
• Limited evidence currently exists for its efficacy in CMC 1 instability.

Purpose of the Study:

• To evaluate the effectiveness of suture-button stabilization for CMC 1 instability.
• To assess outcomes including pain, function, stability, and complications.

Main Methods:

• Retrospective review of 13 patients (4 adolescents) with CMC 1 instability treated with suture-button stabilization.
• Patients had either chronic instability or acute traumatic dislocation with persistent instability.
• Outcomes measured included VAS pain, Kapandji scores, pinch strength, complications, and return to activity.

Main Results:

• Significant reduction in VAS pain scores (mean decrease of 4.43 points) and improvement in Kapandji scores (mean increase of 1.57 points) were observed in chronic instability patients.
• All patients regained stability, achieved full opposition, and experienced pain resolution.
• All patients returned to work or sport by 12 weeks with no fixation failures or recurrent subluxations.

Conclusions:

• Suture-button stabilization reliably restores stability and provides pain relief for CMC 1 instability.
• Early functional recovery was noted in patients treated with this technique.
• It presents a viable alternative to ligament reconstruction or Kirschner wire stabilization in select cases.