[Multi-ligaments reconstruction with single tendon with for the treatment of acute joint dislocation of the first carpometacarpal].

ABSTRACT

OBJECTIVE: To explore the clinical outcomes of multi-ligaments reconstruction with single tendon in treating acute joint dislocation of the first carpometacarpal. METHODS: From December 2008 to October 2012, 4 patients with acute dislocation of the first carpometacarpal were treated with single carpi radialis longus tendon to reconstruct periarticular four ligaments, which included dorsal ligament, palmar ligament, dorsal radiocarpal ligament, and intermetacarpal ligament between the first and second. There were 3 males and 1 female aged from 22 to 63 years old with an average of 38.7. X-ray, JAMAR grid strength testing, range of motion of carpometacarpal joint and VAS score were used to evaluate clinical outcomes. RESULTS: All patients were followed up from 6 to 40 months with an average of 19 months. The wound were healed well at stage I. No dislocation of the first carpometacarpal joint and signs of joints degeneration occurred on X-ray at 1, 3 and 6 months after operation. JAMAR grip strength recovered from 60 percent to 90 percent of health wide. The results of ROM showed 3 cases recovered flexion and extension of joints and 1 case limited adduction. VAS score was 0 to 1. CONCLUSION: For acute dislocation of the first carpometacarpal joint, reconstruction four ligaments with single carpi radialis longus tendon can be considered the selected treatment,which can restores joint stability and improve joint function.