Internal brace augmentation improves the biomechanical properties of trapeziometacarpal joint dorsoradial ligament repair - 14/01/24

Doi : 10.1016/j.hansur.2024.101643

Seung-Han Shin ^a,^b,⁎ , Steven S. Shin ^c, Michelle H. McGarry ^a, Thay Q. Lee ^a
^a Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA
^b Department of Orthopedic Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
^c Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

^⁎Corresponding author.

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Highlights

•	The dorsoradial ligament is the most important stabilizer of the trapeziometacarpal joint
•	Internal brace augmentation of trapeziometacarpal joint dorsoradial ligament repair doubles the load to clinical failure
•	Internal brace-augmented repair does not impair range of motion

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Abstract

This study investigated whether dorsoradial ligament repair with internal brace augmentation provided more immediate stability in the trapeziometacarpal joint than dorsoradial ligament repair alone. Seven matched pairs of cadaveric hands were used. One specimen from each pair was assigned to the repair-only group and the other to the repair + internal brace augmentation group. Trapeziometacarpal joint range of motion and translation were quantified under different conditions for both groups: 1) intact, 2) transected dorsoradial ligament, and 3) repaired dorsoradial ligament or repaired dorsoradial ligament plus internal brace augmentation. Load-to-failure tests were performed after repair. Range of motion and translation were increased by dorsoradial ligament transection and were decreased by dorsoradial ligament repair; however, compared to the intact condition, the repair-only group demonstrated greater flexion/extension range, while the repair + internal brace group showed no significant difference in range of motion. Mean loads at 2- and 3-mm displacements were greater in the repair + internal brace group than in the repair-only group (18.0 ± 1.8 N vs 10.8 ± 1.3 N for 2 mm displacement and 35.3 ± 3.7 N vs 23.1 ± 2.9 N for 3 mm displacement, respectively). Internal brace augmentation improved the load-to-failure characteristics of dorsoradial ligament repair without compromising range of motion.