Application of extended ulnar parametacarpal perforator free flap for the reconstruction of total pulp defect of the thumb: A case report.

Many procedures are available for the coverage of thumb pulp defects; however, to gain thumb function and esthetics, a similar tissue is desirable. If the length of the longitudinal defect is <2 cm, a volar advancement flap is appropriate; however, if the flap is >2 cm long or wider, retrograde or free flaps are required. Here, we present a case of thumb pulp reconstruction using an extended ulnar parametacarpal perforator (UPM) flap, which achieved excellent functional and esthetic outcomes. A 46-year-old man underwent reconstruction surgery of his thumb, which was a degloved total pulp. A sensate 5.2 × 3.2 cm UPM flap was designed on the ulnar side of the right palm and transferred to his thumb. The flap donor site was covered with a V-Y advancement flap on the dorsal side of the right hand. At 12 months postoperatively, the patient achieved a functional and natural thumb appearance with high satisfaction. The UPM flap can offer soft tissue similar to the pulp region in the digit without a palm scar at the donor site. This extended application is suitable for the reconstruction of a total pulp defect of the digit and is an alternative option for a hemi-pulp flap from the toe area.

Clinical outcomes after primary repair for thumb ulnar collateral ligament ruptures: a systematic review and meta-analysis.

There is no consensus on the best surgical technique for treating thumb ulnar collateral ligament (UCL) ruptures. This systematic review and meta-analysis investigates which primary repair technique and postoperative immobilization protocol result in the best clinical outcomes. A literature search was conducted in Embase, Medline ALL Ovid, Web of Science Core Selection and Cochrane Central Register of Controlled Trials. Pain, stability, tip pinch strength, key pinch strength, grip strength, return to work and metacarpophalangeal joint range of motion were collected as postoperative outcomes. In total, 29 studies were included. All surgical techniques resulted in satisfactory clinical outcomes, with no significant differences between bone anchor reinsertion, suture fixation, K-wire fixation and a combination of techniques. K-wire immobilization resulted in worse postoperative pain, but similar stability compared to immobilization without a K-wire. Clinical outcomes after thumb UCL repair are excellent, with no differences in clinical outcomes noted among surgical techniques.

U-shaped kirschner wire transfixation: effective treatment for Skier's thumb.

BACKGROUND: Skier's thumb is a type of injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, which can result in bone fragmentation and joint instability. OBJECTIVE: The objective of this study was to compare the traditional Kirschner wire fixation method with the U-shaped Kirschner wire method for treating small bone fragments with displacement, rotation, or instability in skier's fractures. METHOD: A retrospective study was conducted on 30 patients with skier's thumb who were treated at Tianjin Hospital from January 2019 to December 2021. Patients were divided into two groups: Group A received traditional Kirschner wire fixation, while Group B received U-shaped Kirschner wire fixation. Functional assessments and complications during the perioperative period were evaluated. RESULTS: Both surgical methods significantly reduced postoperative pain and increased joint range of motion. Group B had a lower incidence of pain during follow-up and showed significant functional improvement in Tip-pinch and Grip tests compared to Group A. U-shaped Kirschner wire fixation significantly reduced complications during the perioperative period. CONCLUSION: The U-shaped Kirschner wire internal fixation is a safe and effective treatment for the thumb proximal phalanx base ulnar side avulsion fracture.

Biological Versus Nonbiological Reconstruction of the Ulnar Collateral Ligament of the Thumb Metacarpophalangeal Joint: A Retrospective Study.

PURPOSE: The purpose of this study was to compare clinical and radiologic outcomes of biological ligament reconstruction (BLR) versus nonbiological ligament reconstruction (NBLR) for chronic injuries involving the ulnar collateral ligament of the thumb's metacarpophalangeal joint. METHODS: Forty-two patients who underwent static BLR (n = 24) or NBLR (n = 18) were included in this retrospective analysis. Preoperative, postoperative, and contralateral thumb measurements (clinical evaluation, radiographs, and subjective outcome questionnaires) were compared over a mean of 38 months of follow-up. RESULTS: Average postoperative thumb metacarpophalangeal and interphalangeal joint ranges of motion were 2° to 54° and 0 to 71°, respectively, for BLR and 0° to 58° and 0° to 71°, respectively, for NBLR. Average grip and pinch strengths, relative to the unaffected hand, were 102% and 84% versus 103% and 89%, respectively. All patients demonstrated stability with a firm end point, compared with the unaffected thumb. The average Quick Disabilities of the Arm, Shoulder, and Hand score among all patients was 12 for the disability/symptom module, 0 for the sports module, and 17 for the work module. Stiffness was reported among four patients, and no patient sustained wound-related issues or other complications. CONCLUSIONS: Nonbiological ligament reconstruction of the thumb ulnar collateral ligament generates short-term outcomes comparable with those of BLR, potentially allowing for expedited recovery and rehabilitation. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

[Extensor pollicis longus rupture in a pediatric patient: case report and a literature review]. / Rotura del extensor pollicis longus en paciente pediátrico: reporte de caso y revisión de la literatura.

INTRODUCTION: the rupture of the extensor pollicis longus (EPL) tendon is a rare pathology and usually occurs in adult women in relation to distal radius fractures. MATERIAL AND METHODS: we present the case of an adolescent female patient who, after conservative treatment with splinting of a Peterson type I physeal fracture of the radius, suffered an acute extension deficit of the thumb at six weeks, diagnosed with clinical radiological examination as spontaneous rupture of the extensor pollicis longus (EPL). She was treated with extensor pollicis indicis propius (EIP) transfer with satisfactory results and recovering her usual activity one month after surgery. CONCLUSION: this kind of injuries are infrequent in pediatric ages and rarely described in a pediatric patient with immature skeleton, what makes this case something exceptional. It is necessary considering these complications in patients of low ages even with no other risk factors. The most frequent treatment applied in adults as in children is the EIP transference with good results in the long term.

INTRODUCCIÓN: la rotura del tendón extensor pollicis longus (EPL) constituye una patología infrecuente y se presenta normalmente en mujeres adultas en relación con fracturas de radio distal. MATERIAL Y MÉTODOS: se presenta el caso de una paciente adolescente femenino que, tras tratamiento conservador con férula de una fractura fisaria Peterson tipo I en radio, sufre a las seis semanas déficit agudo de extensión del pulgar, diagnosticada mediante examen clínico radiológico de rotura espontánea del extensor pollicis longus. Es tratada por medio de transferencia del extensor propio del índice (EPI) con resultados satisfactorios y recuperación de su actividad habitual al mes postoperatorio. CONCLUSIÓN: este tipo de lesiones son poco frecuentes en edad pediátrica y casi nunca descritas en un paciente pediátrico con inmadurez esquelética, lo cual hace de este caso algo excepcional. Es necesario tener en cuenta este tipo de complicaciones en pacientes de baja edad aún sin otros factores de riesgo asociados. El tratamiento aplicado más frecuentemente, tanto en adultos como en niños, es la transferencia del extensor propio del índice con buenos resultados a largo plazo.

Surgical Treatment of a Neglected Thumb Volar Plate Injury in an 11-Year-Old Girl: A Case Report.

BACKGROUND Volar plate injuries are rare and difficult to diagnose and treat. Only a few cases have been described on the thumb, especially in children, that resulted in swan-neck type deformity. Conservative treatment has been suggested as first-line management, but surgical reconstruction utilizing flexor digitorum superficialis tenodesis has been described for refractive cases. Only a few attempted surgical repairs of the volar plate have been reported, since it is a technically demanding procedure. CASE REPORT We present the case of a neglected thumb volar plate injury in an 11-year-old girl after a thumb hyperextension injury. The patient presented 2 months after her injury with functional disability of her thumb. Magnetic resonance imaging had been performed, with no signs of volar plate injury, and she was consequently treated with an extension-blocking splint, with no effect. Clinical examination raised the suspicion of a thumb volar plate injury, which was confirmed during surgical exploration. Therefore, fixation with a bone anchor was performed, and the metacarpophalangeal joint was immobilized in 20° flexion with a percutaneously inserted Kirschner wire. After splinting for 3 weeks, the patient had 10 sessions of physical therapy. At 6-week follow-up, she presented with excellent active and passive range of motion and absence of pain. CONCLUSIONS Magnetic resonance imaging did not have high sensitivity. Six weeks after surgery, full range of motion was achieved, with no stiffness or tenderness at the first metacarpophalangeal joint, suggesting that a thumb volar plate injury had been managed surgically with a suture anchor with excellent results.

The free Thenar flap for thumb pulp reconstruction: A case report.

The thumb is acknowledged to contribute significantly to hand function, accounting for up to 40% of its overall capability. Consequently, injuries affecting the thumb can have a profound impact on the quality of life experienced by patients. When it comes to the surgical reconstruction of thumb injuries, the primary objective is to promptly provide coverage of the affected area with glabrous skin, thus preserving both the length and functionality of the thumb. Managing injuries specifically involving the thumb pulp can be particularly challenging due to the digit's size and vital role. Acquiring an adequate amount of glabrous soft tissue poses a difficulty in such cases. Various reconstructive approaches, encompassing a range of options on the reconstructive ladder, have been documented for thumb pulp injuries. The most popular options include pedicled flaps and free flaps obtained from both the hands and feet. However, a consensus regarding the optimal method for reconstructing the thumb pulp has yet to be reached. We present a case of total thumb pulp reconstruction for a 40 × 30 mm defect using the free thenar flap in a 65-year-old carpenter who sustained a work-related injury. This flap was designed and raised on the superficial branch of the radial artery with a single subcutaneous vein and a branch of the palmar cutaneous nerve, the flap measured 43 × 32 mm. It was inset transversely with an end-to-end arterial anastomosis to the ulnar digital artery, venous anastomosis to the dorsal digital vein and nerve coaptation to the ulnar digital nerve. The postoperative course was uneventful, and the patient was discharged the following day without any complications. Eight months after surgery, the patient was extremely satisfied with the results of the procedure in terms of both function and appearance. The patient had experienced an improvement in function, sensation, and aesthetics. The patient had a QuickDASH disability/symptom score of 15.91 and a QuickDASH work module score of 18.75; the range of motion in the treated thumb was almost the same as the opposite thumb. The patient successfully resumed work three weeks following the procedure, initially with modified duties, and fully regained their work capacity within six weeks. As the patient's primary concern was their ability to return to work, the utilization of a free thenar flap offered several distinct advantages. These included minimal post-operative complications, facilitated by a single operative site, allowing for reconstruction under regional anesthesia. Moreover, the procedure was conducted in a single stage, enabling the patient to be discharged on the same day without the need for further procedures. Furthermore, similar to several other reconstructive options for the thumb, the utilization of a free thenar flap offered the advantage of providing high-quality, like-for-like glabrous tissue.

Patient-Reported Outcomes and Function After Surgical Repair of the Ulnar Collateral Ligament of the Thumb.

PURPOSE: The purpose of this study was to report prospectively collected patient-reported outcomes of patients who underwent open thumb ulnar collateral ligament (UCL) repair and to find risk factors associated with poor patient-reported outcomes. METHODS: Patients undergoing open surgical repair for a complete thumb UCL rupture were included between December 2011 and February 2021. Michigan Hand Outcomes Questionnaire (MHQ) total scores at baseline were compared to MHQ total scores at three and 12 months after surgery. Associations between the 12-month MHQ total score and several variables (i.e., sex, injury to surgery time, K-wire immobilization) were analyzed. RESULTS: Seventy-six patients were included. From baseline to three and 12 months after surgery, patients improved significantly with a mean MHQ total score of 65 (standard deviation [SD] 15) to 78 (SD 14) and 87 (SD 12), respectively. We did not find any differences in outcomes between patients who underwent surgery in the acute (<3 weeks) setting compared to a delayed setting (<6 months). CONCLUSIONS: We found that patient-reported outcomes improve significantly at three and 12 months after open surgical repair of the thumb UCL compared to baseline. We did not find an association between injury to surgery time and lower MHQ total scores. This suggests that acute repair for full-thickness UCL tears might not always be necessary. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.

Implant-free anatomical reconstruction of thumb metacarpophalangeal joint chronic ulnar collateral ligament injuries.

A technique is described to treat chronic instability of the metacarpophalangeal joint of the thumb caused by rupture of the ulnar collateral ligament using a palmaris longus tendon graft without implants. Good results were obtained in eight patients.

Reconstruction of Thumb Defects Using the Second Dorsal Metacarpal Artery Flap with Two Pivot Points.

BACKGROUND: This study aimed to introduce reconstruction of thumb defects using the second dorsal metacarpal artery (DMA) flap with two pivot points. METHODS: A retrospective study was conducted with 43 patients (group A) who underwent thumb reconstruction using the second DMA flap with two pivot points from July of 2012 to May of 2019. For comparison, the authors reviewed another cohort of 34 patients (group B) undergoing thumb reconstruction using the first DMA flap. Flap sensation and donor-site morbidity were assessed. RESULTS: In group A, the mean two-point discrimination was 8.7 mm (range, 6 to 12 mm) and 9.7 mm (range, 7 to 12 mm) on the innervated and noninnervated flaps at the final follow-up, with a significant difference ( P = 0.012). In group B, the mean two-point discrimination of the flaps was 7.4 mm (range, 6 to 10 mm). By comparison, group B presented better discriminatory sensation than innervated flaps with double pivot points ( P = 0.002). Based on the visual analogue scale score, the mean score of scar pain and appearance of the donor site were 0.1 (range, 0 to 3) and 0.4 (range, 0 to 2) in group A, and 0.5 (range, 0 to 3) and 1.0 (range, 0 to 4) in group B. By comparison, group A presented lower incidence of scar pain ( P = 0.020) and better appearance of the donor site ( P = 0.019). CONCLUSIONS: The second DMA flap with two pivot points has a long vascular pedicle, which allows the flap to repair thumb defects. It is associated with low donor-site morbidity but suboptimal sensory recovery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Clinical and functional outcomes of surgical treatment of grade III ulnar collateral ligament injuries of thumb metacarpophalangeal joint.

OBJECTIVES: The aim of this study was to compare the clinical and functional outcomes of three surgical techniques (subperiosteal suture, bone anchor and direct repair) for the management of severe acute ulnar collateral ligament injuries of the thumb metacarpophalangeal joint with a minimum of 1 year follow-up. MATERIAL AND METHODS: Between 2015 and 2020, 230 collateral ligament injuries required surgical treatment in our department. After the inclusion and exclusion criteria were applied, 100 were included in the study. The Glickel score and functional scores such as QuickDASH and PRWE were assessed. Time to return to work and to sport was quantified. RESULTS: Ulnar collateral ligament injuries affected men who were statistically younger than women (41.8 years old vs 48.3). Subperiosteal suture was the preferred technique (81%), then bone anchor reattachment (12%) and direct repair (7%). All three techniques produced excellent stability (91-100%). Better range of motion was reported in the subperiosteal group, but better strength was found in the bone anchor group. Subperiosteal suture had 89% excellent and good results, while there was 83% in the bone anchor group and 71% in the direct repair group. Mean time to return to work was 2 months in the bone anchor group versus 3 months in the subperiosteal group. Mean QuickDASH was 8.7/100 and mean PRWE was 7.1/100. CONCLUSION: This is the biggest case series to date on surgical treatment of severe ulnar collateral ligament injuries of the thumb metacarpophalangeal joint. The subperiosteal technique is simpler and less expensive. While the results are not often described in the literature, it produces comparable clinical and functional outcomes to bone anchor reattachment with a minimum follow-up of 1 year.

[The second dorsal metacarpal artery flap relaying the dorsal island flap of the index finger for the repair of soft tissue defect of thumb].

Objective: To investigate the effectiveness of the second dorsal metacarpal artery fascial vascular pedicle retrograde island flap relaying the dorsal island flap of the index finger in repairing skin and soft tissue defects of the thumb. Methods: The clinical data of 8 patients with skin and soft tissue defects of thumb between October 2019 and January 2021 were retrospectively analyzed. There were 3 males and 5 females with an average age of 35 years (range, 18-52 years). The causes of injury included machine injury in 2 cases, crush injury in 3 cases, and cutting injury in 3 cases. There were 2 cases of dorsal defect of the proximal part, 1 dorsal defect of the distal part, and 5 instances of the distal part defect. The skin and soft tissue defects ranged from 1.7 cm×1.4 cm to 3.0 cm×2.5 cm. The time from injury to flap repair was 7-21 days, with an average of 14 days. Firstly, the dorsal island flap of the index finger (dorsal side of the proximal part of the index finger) was used to repair the defect of the thumb. Then the second dorsal metacarpal artery fascia vascular pedicle retrograde island flap (near the radial side of the back of the hand) was used to repair the dorsal defect of the index finger; the donor site was sutured directly. Results: Vascular crisis of the flap occurred in 1 case within 48 hours after operation, and the flap was bloated and bruised in 1 case due to excessive suture tension, and all the flaps survived after symptomatic treatment; partial skin margin of the flap was necrotic in 1 case after operation, and the incision healed after dressing change; the other 5 flaps survived, and all the wounds in the donor and recipient sites healed by first intention. All the 8 patients were followed up 3-10 months, with an average of 6 months. One patient had mild scar; the other patients had no significant difference in the color of the flap and the surrounding skin, no adhesion of tendons, and little interference of index finger function, and there was no obvious pain and dysfunction in the donor and recipient sites of the flap. At last follow-up, the extension-flexion range of motion of the metacarpophalangeal joint of the thumb was 0°-55°, and that of the interphalangeal joint was 0°-75°; the extension-flexion range of motion of the metacarpophalangeal joint of the index finger was 0°-82°, that of the proximal interphalangeal joints was 0°-90°, and that of the distal interphalangeral joints was 0°-65°. Conclusion: The application of the second dorsal metacarpal artery fascial vascular pedicle retrograde island flap relaying the dorsal island flap of the index finger to repair skin and soft tissue defect wounds of thumb is a feasible treatment with reliable blood supply, less postoperative complications, no need for skin grafting, less interference to the function of the index finger, and satisfactory wound repair effect.

A mini hallux neurovascular osteo-onychocutaneous free flap for refined reconstruction of distal defects in thumbs and fingers.

Distal injury in thumbs and fingers is common in emergency. Although multiple surgical techniques have been introduced for repair purpose, it is still challenging for restoring both good function and cosmetic appearance. The present study reports our experiences on how to reconstruct amputated fingertips in thumbs and fingers using a mini hallux neurovascular osteo-onychocutaneous free flap with favorable outcomes in 15 patients (average age, 27.27 ± 5.43 years old). Follow-up period was 19.47 ± 10.18 months (range, 6-48 months). Digital function was improved indicated by the static two-point discrimination (2-PD) and key-pinch, which were 8.40 ± 1.64 mm (range, 6-12 mm) and 85.37 ± 3.03% (range, 80.2-90.6%) of that of the intact contralateral thumbs and fingers, respectively, after surgery. As to aesthetic outcomes, all reconstructed digits were self-graded as good by patients. 73.3% of the donor halluces were self-graded as good and four halluces (26.7%) were graded as fair. In conclusion, the mini hallux neurovascular osteo-onychocutaneous flap may be used for refined reconstruction of type I amputated injury in thumbs and fingers achieving both satisfactory functional and aesthetic outcomes.

Outcomes of Coverage of Soft Tissue Defects in the Thumb with a "Kite Flap".

Deep soft tissue injuries and defects in the digits such as pulp amputation and degloving injuries are relatively frequent in hand surgical practice. Injuries around the thumb constitute a specific subtype, because their fitting requires the use of techniques that are different from standard. Many different surgical options have been described for the treatment of these serious lesions, depending on site and size of the defect, as well as on bone exposition. The "kite flap" is one of the most popular and frequently used. Results of the treatment of 14 of the 22 patients whose defects in the thumb were fitted with the kite flap are presented. The flaps healed in all patients. At the mean follow-up of 3 years all patients declared satisfaction with the result of surgery. Most of them had slightly limited mobility of the operated thumbs but with no significant translation to the function of the hands, which was very good. The results of this study show that the kite flap is useful in reconstruction of soft tissue defects around the thumb, which are difficult to cover by more conventional techniques.

Reverse homodigital dorsal wraparound flap for reconstruction of distal thumb.

Reconstruction of degloving injury or amputation of distal thumb with no indication of replantation has always been a challenging problem for hand surgeons. In this study, a reverse homodigital dorsal wraparound flap innervated by the dorsal digital nerve was devised to repair degloving injury or amputation of distal thumb in 20 consecutive cases. In nine cases of thumb amputation, we skeletonized the phalanxes of the amputated part as a free cortical bone with Kirschner wires. All flaps survived uneventfully. The radiographs showed bone healing in all the patients of thumb amputation within 6 weeks postoperatively. At final follow-up, the appearance of the reconstructed thumb was acceptable and flap sensation and range of joint motion were satisfactory. This flap is a simple and reliable alternative method for degloving injury or amputation of distal thumb when replantation is impossible and patients refuse to donate tissues from toes. Type of study/level of evidence Therapeutic IV.

Six-Strand Flexor Pollicis Longus Tendon Repairs With and Without Circumferential Sutures: A Multicenter Study.

BACKGROUND: The purpose of this study is to assess outcomes in flexor pollicis longus tendon repairs with 6-strand core sutures with and without circumferential sutures. METHODS: A 6-strand core suture technique with and without circumferential sutures was used. Thirty-three patients were summarized in the C group (circumferential group) and 16 patients in the NC group (non-circumferential group). After the surgery, the wrist was stabilized with a dorsal blocking splint and a controlled early active motion protocol was applied. At weeks 6, 13, and 26 data on demographics, type of injury, surgery, postoperative rehabilitation, complications such as re-rupture and the following outcome measurements were collected: range of motion and its recovery according to the Tang criteria, Kapandji score, thumb and hand strengths, Disabilities of the Arm, Shoulder and Hand score, and satisfaction. RESULTS: There were no significant differences in range of motion and strength between the 2 treatment groups. In both groups, the outcome measurements increased over time and they expressed similar satisfaction with the surgical treatment. In 4 patients of the C group tendon repair ruptured and in 1 patient of the NC group. CONCLUSIONS: Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries and good results can also be achieved by omitting the circumferential suture.

Use of an Abductor Pollicis Brevis Tendon Slip for Reconstruction of the Radial Collateral Ligament of the Thumb Metacarpophalangeal Joint: An Anatomical Investigation.

BACKGROUND: Reconstruction of the radial collateral ligament (RCL) of the thumb metacarpophalangeal (MP) joint is commonly performed for chronic injuries. This study aims to evaluate the anatomical feasibility and reliability of using the abductor pollicis brevis (APB) tendon to reconstruct the RCL. METHODS: Ten cadaver arms were dissected to evaluate the relationship between insertions of the RCL and APB. A slip of the APB was divided from tendon and reflected proximally. The dissected tendon was deemed sufficient for reconstruction if it could be reflected to the footprint of the RCL origin. The size of the dissected APB slip was then compared with that of the RCL. RESULTS: The dissected slip of the APB could be fully reflected proximally to the RCL origin in all specimens. The APB insertion was also found to be closely approximated to the RCL insertion, averaging 2.1 mm distal and 1.8 mm dorsal. Significant differences existed between the lengths (P < .001) of the APB slip and RCL, with no significant difference in widths (P = .051). CONCLUSIONS: A sufficient APB tendon slip can be obtained to reliably reconstruct the RCL of the thumb MP. The location of the APB insertion closely approximates the RCL insertion.

Acute Thumb Reconstruction with Iliac Crest Bone Graft and Groin Flap: A Case Report.

Crush injury with bone loss results in shortening the length of the thumb. Most of the immediate intervention is amputation and stump closure. Revision amputation with stump closure gives loss of functional length and the patient is unable to do daily activities as before. In most of all hand functions, the opposition of the thumb plays an important role. Reconstruction of the thumb with iliac crest bone graft with its functional length is one of the major achievements for the patient. As in our case, the patient is right-hand dominant he is more concerned about the functional length of the thumb, whatever the aesthetic appearance. Here we present a case of a 24-year-old male with thumb reconstruction in a severely injured thumb with loss of bone and soft tissue just distal to the base of the proximal phalanx. Nine months postoperatively, the patient showed a great outcome with restored thumb length, function, grip strength, and a good range of motion. Keywords: case reports; injury; thumb.

Outcome Following Acute Suture Anchor Repair of the Ulnar Collateral Ligament of the Thumb.

Background: The aim of this study was to evaluate the outcomes following acute repair of the ulnar collateral ligament of the thumb metacarpophalangeal joint (thumb UCL) using a suture anchor technique. Methods: From 2011 to 2019, we retrospectively identified 40 adult patients from a single centre who had undergone an acute thumb UCL repair (≤6 weeks post-injury). The mean age of the study cohort was 37 years (range 16-70) and 68% (n = 27/40) were male. The short-term outcomes included postoperative complications and failure of repair. The long-term outcomes were QuickDASH, the EuroQol 5-Dimension (EQ-5D), Visual Analogue Scale (EQ-VAS), return to sport and work and satisfaction with outcome. Results: The outcomes survey was completed at a mean of 4.3 years (range 1.0-9.2) for 33 patients (83%). Postoperative complications included self-limiting sensory disturbance (7.5%, n = 3/40), superficial infection (requiring oral antibiotics; 5%, n = 2/40) and wound dehiscence (requiring surgical debridement and re-closure; 2.5%, n = 1/40). No failures of repair were reported. The mean QuickDASH was 3.7 (range 0-27.3), EQ-5D 0.821 (range -0.041 to 1) and EQ-VAS 84 (range 60-100). Of the 32 employed patients, all returned to work at a median of 0.5 weeks (range 0-416) and the mean QuickDASH Work Module was 4.1 (range 0-50). Of the 24 patients playing sport prior to injury, 96% (n = 23/24) returned at a median of 16 weeks (range 5-52) and the mean QuickDASH Sport Module was 4.6 (range 0-25). All the patients were satisfied with their outcome (mean satisfaction score 9.8/10 [8-10O]). Conclusions: Thumb UCL repair using a suture anchor technique is safe and effective up to 6 weeks post injury. Pain and stiffness may persist in the longer term, but most patients report excellent upper limb function and health-related quality of life. The majority return to work and sport and are highly satisfied with their outcome. Level of Evidence: Level IV (Therapeutic).