Swagat Mahapatra
Dr Ram Manohar Lohia Institute of Medical Sciences, India
Title: Functional analysis of ulnar collateral ligament reconstruction of thumb using free tendon graft by pull out suture technique in neglected skiers thumb
Biography
Biography: Swagat Mahapatra
Abstract
Injury to the ulnar collateral ligament (UCL) is referred to as game keeper’s thumb and is a rare injury in paediatric age group. Excessive valgus stress to the base of the thumb may result in disruption of the (UCL) complex with or without an avulsion fracture of the base of the proximal phalanx. We present a 14 years old girl with history of twisting injury to the right thumb two years back. She had a weakness of pincer grip, holding a pen, grasping objects and unscrewing jar lids. On clinical examination, tenderness was present in MCP joint, thumb instability test was positive. There was laxity of <35° on stressing the thumb without a firm end point. Stress radiograph showed opening up of the joint. MRI showed complete tear of ulnar collateral ligament. Patient underwent UCL reconstruction with palmaris longus graft using a pull-out suture technique with a transosseous non absorbable suture tied over a button on the radial side of the MCP Joint. Intra operatively thumb was stable. Thumb spica was applied for six weeks. After six weeks button was removed. At the final follow up of six months, joint was stable and she was able to do her daily activities. A pull-out suture technique UCL reconstruction has a satisfactory fixation, faster healing rate and results in good joint stability. We report this case due to the rarity of ulna collateral ligament injury of thumb in children.