Comparison of functional results after early controlled motion for surgical repair of acute and chronic ulnar collateral ligament injury of the thumb - 15/07/18
Résumé |
Introduction/Background |
Injuries to the UCL can lead to functional impairment. Rehabilitation is very important for functional results. Early motion after surgery is avoided. Usually the controlled motion starts after the 6th week. The aim of this study was to evaluate functional results of early controlled motion before 6th week.
Material and method |
Nineteen patients (18♂/1♀) had an acute UCL rupture, 25 patients (23♂/2♀) had a chronic UCL rupture. Two soft anchors (Mini 1.0mm) were used to repair ruptured UCL to bone insertion at the acute UCL injury group. For chronic UCL injury group, 3.0mm bone tunnels were prepared to proximal and distal insertion of UCL and than tendon graft was passed through the tunnels. The tendon graft was stabilized by placing 3.0-mm bioabsorbable suture anchors within the tunnels. The motion was restricted in the 2 week with thumb spica. Dynamic splint and passive ROM exercises were started after 2 week. Active ROM exercises were started after 4 week.
Results |
There were no significant differences between the two groups in the men/women ratio, mean age, mean follow-up period. All patients regained full stability at MCP joint in acute UCL injury group; 21 patients regained full stability and 4 patients presented with mild laxity (<10° laxity) in chronic UCL injury group. The ROM of injured MCP joint of thumb was regained at 8–10 week as good as healthy extremity MCP joint of thumb. There were no significant differences between operated and healthy thumb MCP joint in both groups in the grip and pinch strength, flexion, extension, radial deviation, ulnar deviation motions at final control. Glickel grading scale was excellent for 19 patients for acute UCL injury group; it was excellent for 21 patients and good for 3 patients in chronic UCL injury group.
Conclusion |
Early controlled motions affect functional results positively. Repair with 1-mm soft anchors in acute UCL injury and reconstruction with tendon graft which stabilized by 3-mm bioabsorbable suture anchors within the tunnels in chronic UCL injury provides adequate stability for early controlled motion.
Le texte complet de cet article est disponible en PDF.Keywords : Early controlled motion, Acute ulnar collateral ligament injury of thumb, Chronic ulnar collateral ligament injury of thumb
Plan
Vol 61 - N° S
P. e165-e166 - juillet 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.