TY - JOUR
T1 - The Figure-of-Eight Ligament Reconstruction in Thumb Carpometacarpal Instability
T2 - Surgical Technique and Clinical Outcomes
AU - Jongen, Isabel C.
AU - Nieuwdorp, Niek J.
AU - the Hand-Wrist Study Group
AU - Hundepool, C. A.
AU - Van der Oest, Mark J.W.
AU - Moojen, Thybout M.
AU - Selles, Ruud W.
AU - Zuidam, Jelle Michiel
AU - Blomme, Arjen R.A.M.
AU - Smit, Jeroen M.
AU - Harmsen, Kennard
AU - Halbesma, Gertjan
AU - Vermeulen, Guus M.
AU - de Schipper, Hans P.
AU - van Uchelen, Jeroen H.
AU - Zöphel, Oliver T.
AU - Souer, J. Sebastiaan
AU - Lopez, Lisa E.
AU - Fink, Alexandra
AU - van Huis, Rob
AU - Pennehouat, Pierre-Yves A.A.
AU - Schoneveld, Karin
AU - Arends, Grada D.
AU - Feitz, Reinier
AU - Hoogendam, Lisa
AU - Hovius, Steven E.R.
AU - van Kooij, Yara E.
AU - Koopman, Jaimy E.
AU - Van der Oest, Mark J.W.
AU - de Ridder, Willemijn A.
AU - van Wijk, Lyse
AU - Bijlsma, Ward R.
AU - Colaris, Joost W.
AU - Duraku, Liron S.
AU - van der Heijden, E.P.A. (Brigitte)
N1 - Publisher Copyright:
© 2024 American Society for Surgery of the Hand
PY - 2024/8/1
Y1 - 2024/8/1
N2 - PURPOSE: This study reviewed the results of the figure-of-eight ligament reconstruction, a technique used in the surgical management of thumb carpometacarpal (CMC) instability. This technique establishes joint stability through forces originating within the CMC joint, providing volar and dorsal support.METHODS: We evaluated the outcomes of 15 patients with nontraumatic, nonarthritic thumb CMC instability treated with the figure-of-eight ligament reconstruction technique. This technique involves routing a graft of the palmaris longus tendon through the base of the first metacarpal and trapezium bone in a figure-of-eight fashion. Preoperative visual analog scale (0-100) for pain and Michigan Hand Outcomes Questionnaire total scores were compared with 3- and 12-month postoperative scores. Secondary outcomes included strength, range of motion, patient satisfaction, return to work, and complications.RESULTS: A significant improvement between intake and 12 months after surgery was observed for both Michigan Hand Outcomes Questionnaire total scores (53, SD 3 vs 70, SD 4) and visual analog scale pain scores (63, SD 4 vs 36, SD 7). Additionally, after surgery, restored thumb CMC joint stability was reported for all patients. Strength and range of motion improved between intake and 12 months after surgery. The median return to work was 6 weeks. Nine (60%) patients rated their satisfaction as "excellent" or "good," and 11 (73%) patients said that they would undergo the surgery again.CONCLUSIONS: The figure-of-eight ligament reconstruction significantly improves pain and function in patients with thumb CMC instability while restoring joint stability and preserving range of motion, making it a suitable technique.TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
AB - PURPOSE: This study reviewed the results of the figure-of-eight ligament reconstruction, a technique used in the surgical management of thumb carpometacarpal (CMC) instability. This technique establishes joint stability through forces originating within the CMC joint, providing volar and dorsal support.METHODS: We evaluated the outcomes of 15 patients with nontraumatic, nonarthritic thumb CMC instability treated with the figure-of-eight ligament reconstruction technique. This technique involves routing a graft of the palmaris longus tendon through the base of the first metacarpal and trapezium bone in a figure-of-eight fashion. Preoperative visual analog scale (0-100) for pain and Michigan Hand Outcomes Questionnaire total scores were compared with 3- and 12-month postoperative scores. Secondary outcomes included strength, range of motion, patient satisfaction, return to work, and complications.RESULTS: A significant improvement between intake and 12 months after surgery was observed for both Michigan Hand Outcomes Questionnaire total scores (53, SD 3 vs 70, SD 4) and visual analog scale pain scores (63, SD 4 vs 36, SD 7). Additionally, after surgery, restored thumb CMC joint stability was reported for all patients. Strength and range of motion improved between intake and 12 months after surgery. The median return to work was 6 weeks. Nine (60%) patients rated their satisfaction as "excellent" or "good," and 11 (73%) patients said that they would undergo the surgery again.CONCLUSIONS: The figure-of-eight ligament reconstruction significantly improves pain and function in patients with thumb CMC instability while restoring joint stability and preserving range of motion, making it a suitable technique.TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
UR - http://www.scopus.com/inward/record.url?scp=85200754510&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2024.05.017
DO - 10.1016/j.jhsa.2024.05.017
M3 - Article
C2 - 39093240
SN - 0363-5023
JO - The Journal of hand surgery (U.S.)
JF - The Journal of hand surgery (U.S.)
ER -