Ligament Reconstruction by Extensor Carpi Radialis Longus Tendon for Instability of Thumb CM Joint

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  • 母指ＣＭ関節不安定性に対する靭帯再建術の経験

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Abstract

Seven consecutive ligament reconstructions by extensor carpi radialis longus tendon for the instability of the thumb CM joint were reviewed in seven patients. They consisted of two males and five females, and their age ranged from 15 to 67 years. Postoperative follow-up periods ranged from six months to six yeas three months (average 2.5 years). According to Eaton's radiographic classification, there were four cases in stage I and three in stage II.<BR>The procedure was performed in accordance with University of Ryukyu's method. The half slip of ECRL tendon is passed through the bony tunnel made at the base of the first and second metacarpal, then it was sutured to itself under sufficient tension.<BR>Each case was evaluated by Eaton's clinical criteria, thumb CM joint range of motion, pinch power, grip power, and radiographic estimation.<BR>Overall results were excellent in five cases, good in one, and failed in one. The failed case was re-injured by traffic accident postoperatively. Except for this case, all cases achieved good results in terms of relief of pain. There were no significant differences with regard to thumb CM joint range of motion, pinch power, and grip power pre-and post-operatively. The operative radiographic stage did not progress in all cases, although one had minimum laxity.<BR>Ligament reconstruction by ECRL tendon may be a useful surgical procedure for unstable thumb CM joint.

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