Skip to main content
Top
Published in: HAND 2/2015

01-06-2015 | Surgery Articles

Thumb volar plate reconstruction utilizing extensor pollicis brevis autograft: evaluation of a new technique

Authors: Kenneth F. Taylor, Jeffrey A. Levy

Published in: HAND | Issue 2/2015

Login to get access

Abstract

Background

Sagittal plane instability of the thumb metacarpophalangeal joint is a difficult problem with numerous surgical techniques described. The purpose of the study is to demonstrate a technique in which a distally based extensor pollicis brevis tendon autograft is utilized to reconstruct the deficient volar plate.

Methods

This is a retrospective case series of four patients who were followed a minimum of 2 years after this procedure. Patient demographics, return to work status, and objective outcomes are reported.

Results

This technique compared favorably to those previously described, in terms of technical ease, functional results, and patient satisfaction. Each patient returned to his previous activity level and was maintained on active duty in his current military occupational specialty. None required a permanent profile to limit the physical demands of his job.

Conclusions

Preliminary data suggests this technique is anatomically sound, technically less demanding, and requires minimal surgical dissection compared to previously described procedures.
Literature
1.
go back to reference Eaton RG, Floyd WE. Thumb metacarpophalangeal capsulodesis: an adjunct procedure to basal joint arthroplasty for collapse deformity of the first ray. J Hand Surg [Am]. 1988;13:461–5.CrossRef Eaton RG, Floyd WE. Thumb metacarpophalangeal capsulodesis: an adjunct procedure to basal joint arthroplasty for collapse deformity of the first ray. J Hand Surg [Am]. 1988;13:461–5.CrossRef
2.
go back to reference Eiken O. Palmaris longus tenodesis for hyperextension of the thumb metacarpophalangeal joint. Scand J Plast Reconstr Surg. 1981;15:149–52.CrossRefPubMed Eiken O. Palmaris longus tenodesis for hyperextension of the thumb metacarpophalangeal joint. Scand J Plast Reconstr Surg. 1981;15:149–52.CrossRefPubMed
3.
go back to reference Filler BC, Stark HH, Boyes JH. Capsulodesis of the metacarpophalangeal joint of the thumb in children with cerebral palsy. J Bone Joint Surg Am. 1976;58:667–70.PubMed Filler BC, Stark HH, Boyes JH. Capsulodesis of the metacarpophalangeal joint of the thumb in children with cerebral palsy. J Bone Joint Surg Am. 1976;58:667–70.PubMed
4.
go back to reference Kessler I. A simplified technique to correct hyperextension deformity of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am. 1979;61:903–5.PubMed Kessler I. A simplified technique to correct hyperextension deformity of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am. 1979;61:903–5.PubMed
5.
go back to reference Lim GJ, Yam A, Tay SC, et al. A split-EPB tendon sling for chronic post-traumatic palmar instability of the thumb metacarpophalangeal joint. J Hand Surg Eur. 2009;34:358–62.CrossRef Lim GJ, Yam A, Tay SC, et al. A split-EPB tendon sling for chronic post-traumatic palmar instability of the thumb metacarpophalangeal joint. J Hand Surg Eur. 2009;34:358–62.CrossRef
6.
go back to reference Lyons RP, Kozin SH, Failla JM. The anatomy of the radial side of the thumb: static restraints in preventing subluxation and rotation after injury. Am J Orthop. 1998;27:759–63.PubMed Lyons RP, Kozin SH, Failla JM. The anatomy of the radial side of the thumb: static restraints in preventing subluxation and rotation after injury. Am J Orthop. 1998;27:759–63.PubMed
7.
go back to reference Moberg E, Stener B. Injury to the ligament of the thumb and fingers. Acta Chir Scand. 1953;106:166–86.PubMed Moberg E, Stener B. Injury to the ligament of the thumb and fingers. Acta Chir Scand. 1953;106:166–86.PubMed
8.
go back to reference Posner MA, Langa V, Ambrose L. Intrinsic muscle advancement to treat chronic palmar instability of the metacarpophalangeal joint of the thumb. J Hand Surg [Am]. 1988;13:110–5.CrossRef Posner MA, Langa V, Ambrose L. Intrinsic muscle advancement to treat chronic palmar instability of the metacarpophalangeal joint of the thumb. J Hand Surg [Am]. 1988;13:110–5.CrossRef
9.
go back to reference Schuurman AH, Bos KE. Treatment of volar instability of the metacarpophalangeal joint of the thumb by volar capsulodesis. J Hand Surg (Br). 1993;18:346–9.CrossRef Schuurman AH, Bos KE. Treatment of volar instability of the metacarpophalangeal joint of the thumb by volar capsulodesis. J Hand Surg (Br). 1993;18:346–9.CrossRef
10.
go back to reference Stener B. Hyperextension injuries to the metacarpophalangeal joint of the thumb—rupture of ligaments, fracture of sesamoid bones, rupture of flexor pollicis brevis. An anatomical and clinical study. Acta Chir Scand. 1963;125:275–93.PubMed Stener B. Hyperextension injuries to the metacarpophalangeal joint of the thumb—rupture of ligaments, fracture of sesamoid bones, rupture of flexor pollicis brevis. An anatomical and clinical study. Acta Chir Scand. 1963;125:275–93.PubMed
11.
go back to reference Tonkin MA, Beard AJ, Kemp SJ, et al. Sesamoid arthrodesis for hyperextension of the thumb metacarpophalangeal joint. J Hand Surg [Am]. 1995;20:334–8.CrossRef Tonkin MA, Beard AJ, Kemp SJ, et al. Sesamoid arthrodesis for hyperextension of the thumb metacarpophalangeal joint. J Hand Surg [Am]. 1995;20:334–8.CrossRef
12.
go back to reference Zancolli EA. Claw-hand caused by paralysis of the intrinsic muscles: a simple surgical procedure for its correction. J Bone Joint Surg Am. 1957;39:1076–80.PubMed Zancolli EA. Claw-hand caused by paralysis of the intrinsic muscles: a simple surgical procedure for its correction. J Bone Joint Surg Am. 1957;39:1076–80.PubMed
Metadata
Title
Thumb volar plate reconstruction utilizing extensor pollicis brevis autograft: evaluation of a new technique
Authors
Kenneth F. Taylor
Jeffrey A. Levy
Publication date
01-06-2015
Publisher
Springer US
Published in
HAND / Issue 2/2015
Print ISSN: 1558-9447
Electronic ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-014-9687-x

Other articles of this Issue 2/2015

HAND 2/2015 Go to the issue