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Outcomes of Pediatric Metacarpophalangeal Ulnar Collateral Ligament Reconstruction with Internal Brace
Mary M. Holohan, BS, Jeffrey N. Gross, MD, Nikhi Singh, MD, Joshua Adkinson, MD
Indiana University School of Medicine
2023-01-31
Presenter: Mary M. Holohan
Affidavit:
Mary M. Holohan, BS, Jeffrey N. Gross, MD, Nikhi Singh, MD, Joshua Adkinson, MD
Director Name: William Wooden, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction:
Injuries of the digital collateral ligaments are common. Most cases involve the thumb and occur at metacarpophalangeal (MCP) joints. Historically, ligament repair was performed either by direct repair/reinsertion or reconstruction with an autologous graft. The use of suture tape (e.g. Internal Brace [IB]) is a novel technique developed to augment repair of thumb MCP ulnar collateral ligament (UCL) and has been shown to provide biomechanical support and allow for more rapid rehabilitation and return to activities. Repair using IB alone has yet to be investigated in the pediatric population.
Methods:
A retrospective review of patients was performed. Inclusion criteria were patients under 18 years old at Riley Children's Hospital who underwent UCL repair with IB only from 2019-2022. We collected pain scores, strength, and range of motion following surgery.
Results:
Three pediatric patients underwent repair of a MCP UCL using suture tape alone. Patients were evaluated an average of 8.3 months postoperatively for pain (VAS), pinch and grip strength, and MCP joint ulnar/radial laxity with stress. In this series, patients obtained an average pinch and grip strength of 78 and 97 percent of their non-operated hand, respectively. Degree of laxity during MCP radial stress (assessing UCL) averaged 13.3 degrees, compared to 18.3 degrees when placing an ulnar stress (assessing RCL) on the injured digit.
Conclusion:
This is the first clinical application of IB alone in repair of the UCL in a pediatric population. These data indicate that IB alone-repair of the UCL is a viable technique in pediatric patients.
