Gamekeeper’s Thumb Reconstructive Surgical Techniques Injury to the UCL ligament of the MCP joint of the thumb can be a very common injury which can lead to long-term problems for patients if untreated. Gamekeeper’s thumb is the chronic version of this injury and Skier’s thumb is a more acute version of this injury. Gamekeeper’s thumb is a rupture of avulsion of the ulnar collateral ligament in the thumb which occurs from repetitive valgus forces to the ligament. In the medical field today there are various procedures that surgeons use to repair UCL tears. In the article Comparison of results after surgical repair of acute and chronic ulnar collateral ligament injury of the thumb it compared the successful outcomes of a surgical technique
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Thirty two patients had sustained an UCL avulsion fracture and nineteen patients sustained an UCL rupture. For the patients with an UCL rupture the surgical technique used consisted of, the surgeon drilled into the proximal and distal insertion sites for the UCL ligament using a 2.5 mm bit to construct the tunnel for the free tendon graft, for sixteen patients the palmaris longus tendon was used as the graft and for three patients the split flexor carpi radialis tendon was used, that was used in the procedure. The surgeon then used passing sutures to put both ends of the graft through the tunnel with about 1 cm of the graft in each tunnel. To stabilize the free graft tendon endings in each tunnel the surgeon placed 3 mm bioabsorbable suture anchors in the tunnels and placed them through the graft and tied them off. For the patients with an UCL avulsion the surgical technique used consisted of, the surgeon under fluoroscopic control, closed reduced the avulsion fragment. The surgeon then used K-wire fixation by using one K-wire to reduce the fracture by passing the wire through the bone fragment and then the surgeon fixated the fragment with a second K-wire. To confirm the final reduction and fixation A/P and lateral radiographs were …show more content…
After an approval from an institutional review board the patients for this study were obtained after completing a retrospective chart review of them. The patients reviewed had undergone UCL thumb repair from January 2004 till December 2011 and the surgeries were all done by the senior author. The surgical technique used in this study was that first the insertion of the UCL ligament was scraped to bare. A Minilok suture anchor that with 2-0 braided polyester suture was then placed in the insertion of the UCL on the proximal phalanx. Then a Microfix suture anchor that with 4-0 braided polyester suture was placed on proximal phalanx that was adjacent to the first suture anchor. Both of the suture anchors were then used to reattach the UCL ligament back to its insertion on the proximal phalanx. The results of this study was that the 18 college football players were all able to return to at least the same level of play before they sustained injuries to their UCLs. Six of the football players who had surgery actually went on to play football at the professional level.
Thirty two patients had sustained an UCL avulsion fracture and nineteen patients sustained an UCL rupture. For the patients with an UCL rupture the surgical technique used consisted of, the surgeon drilled into the proximal and distal insertion sites for the UCL ligament using a 2.5 mm bit to construct the tunnel for the free tendon graft, for sixteen patients the palmaris longus tendon was used as the graft and for three patients the split flexor carpi radialis tendon was used, that was used in the procedure. The surgeon then used passing sutures to put both ends of the graft through the tunnel with about 1 cm of the graft in each tunnel. To stabilize the free graft tendon endings in each tunnel the surgeon placed 3 mm bioabsorbable suture anchors in the tunnels and placed them through the graft and tied them off. For the patients with an UCL avulsion the surgical technique used consisted of, the surgeon under fluoroscopic control, closed reduced the avulsion fragment. The surgeon then used K-wire fixation by using one K-wire to reduce the fracture by passing the wire through the bone fragment and then the surgeon fixated the fragment with a second K-wire. To confirm the final reduction and fixation A/P and lateral radiographs were …show more content…
After an approval from an institutional review board the patients for this study were obtained after completing a retrospective chart review of them. The patients reviewed had undergone UCL thumb repair from January 2004 till December 2011 and the surgeries were all done by the senior author. The surgical technique used in this study was that first the insertion of the UCL ligament was scraped to bare. A Minilok suture anchor that with 2-0 braided polyester suture was then placed in the insertion of the UCL on the proximal phalanx. Then a Microfix suture anchor that with 4-0 braided polyester suture was placed on proximal phalanx that was adjacent to the first suture anchor. Both of the suture anchors were then used to reattach the UCL ligament back to its insertion on the proximal phalanx. The results of this study was that the 18 college football players were all able to return to at least the same level of play before they sustained injuries to their UCLs. Six of the football players who had surgery actually went on to play football at the professional level.