The Figure-of-Eight Ligament Reconstruction in Thumb Carpometacarpal Instability: Surgical Technique and Clinical Outcomes

Isabel C. Jongen*, Niek J. Nieuwdorp, the Hand-Wrist Study Group, C. A. Hundepool, Mark J.W. Van der Oest, Thybout M. Moojen, Ruud W. Selles, Jelle Michiel Zuidam

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Downloads (Pure)

Abstract

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.

Original languageEnglish
JournalThe Journal of hand surgery (U.S.)
DOIs
Publication statusPublished - 1 Aug 2024

Bibliographical note

Publisher Copyright:
© 2024 American Society for Surgery of the Hand

Fingerprint

Dive into the research topics of 'The Figure-of-Eight Ligament Reconstruction in Thumb Carpometacarpal Instability: Surgical Technique and Clinical Outcomes'. Together they form a unique fingerprint.

Cite this