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J Hand Surg Am ; 49(5): 432-442, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38506782

RESUMEN

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.


Asunto(s)
Ligamento Colateral Cubital , Articulación Metacarpofalángica , Rango del Movimiento Articular , Pulgar , Humanos , Pulgar/cirugía , Pulgar/lesiones , Articulación Metacarpofalángica/cirugía , Estudios Retrospectivos , Masculino , Femenino , Adulto , Rango del Movimiento Articular/fisiología , Ligamento Colateral Cubital/cirugía , Ligamento Colateral Cubital/lesiones , Persona de Mediana Edad , Reconstrucción del Ligamento Colateral Cubital , Fuerza de la Mano , Resultado del Tratamiento , Evaluación de la Discapacidad , Adulto Joven , Procedimientos de Cirugía Plástica/métodos , Ligamentos Colaterales/cirugía , Ligamentos Colaterales/lesiones
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