Arch Hand Microsurg 2018; 23(4): 254-261  
Comparison between Chronic Ulnar and Radial Collateral Ligament Repairs in the Metacarpophalangeal Joint of the Thumb
Sanglim Lee1, Jiyun Ha1, Ji Yeong Kim2, Suk Ha Jeon3
1Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital, Seoul, Korea
2Gunganhan Orthopedic Surgery Clinic, Seoul, Korea
3Department of Orthopedic Surgery, National Medical Center, Seoul, Korea
Correspondence to: Suk Ha Jeon
Department of Orthopedic Surgery, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea
TEL: +82-2-2260-7189, FAX: +82-2-2278-9570, E-mail: lotusjeon@gmail.com
Received: September 7, 2018; Revised: October 10, 2018; Accepted: October 25, 2018; Published online: December 1, 2018.
© Korean Society for Surgery of the Hand, Korean Society for Microsurgery, and Korean Society for Surgery of the Peripheral Nerve. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint.
Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month followup. The data between 6 radial and 8 ulnar ligament repairs were compared statistically.
Results: The average of postoperative ulnar deviation angle was 13.3° in radial ligament and 2.0° in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs.
Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.
Keywords: Thumb, Metacarpophalangeal joint, Collateral ligament, Suture anchors


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