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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 1999 October;50(5):185-90
Lesion of the ulnar collateral ligament of the thumb
Ferrari P. R.
Background. The ulnar collateral ligament injury is a well known traumatic pathology. This study aims to verify, with a personal trial, the techniques and results reported in the literature.
Methods. Between 1992 and 1995, 22 patients with acute and 7 with chronic UCL injury underwent surgical treatment at the Orthopedics Dept., University of Brescia: Fifteen out of 22 recent lesions were directly sutured with reabsorbing stitches; 5, with bone fragment, were treated with wire pull-out and 2 cases with ''through bone'' stitches. In three chronic cases free tendon grafting with palmaris longus was used, in 1 an arthrodesis of MPI was made, in 1 case ''pierce through bone'' stitches and 2 cases with direct suture (they refused any tendon graft). All the patients, at 2.5 years follow-up, were reviewed clinically and tested with dynamometer at both hands.
Results. More than 86% of the patients with acute injury showed a good stability and strenght and 13.6% a sufficient stability and grasp of the MPJ. All the patients treated with free palmaris longus graft and MPJ arthrodesis had a good stability and strenght. The remaining patients showed instability and strenght decrease statistically significant (p¾0.10) between affected and healthy side.
Conclusions. Considering the good results of surgical treatment in acute lesions, the first step to consider is the precociousness of the diagnosis for a correct injury care. In chronic instability the free palmaris longus graft seems to be a safe technique.