gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Surgical repair of dorsal capsulo-ligamentous complex for dislocation of the thumb carpometacarpal joint

Meeting Abstract

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  • presenting/speaker Haruhiko Shimura - Tokyo Bay Urayasu-Ichikawa Medical Center, Urayasu, Japan
  • Tetsuya Sato - Doai Memorial Hospital, Tokyo, Japan
  • Yoshiaki Wakabayashi - Yokohama City Minato Red Cross Hospital, Yokohama, Japan
  • Akimoto Nimura - Tokyo Medical and Dental University, Tokyo, Japan
  • Koji Fujita - Tokyo Medical and Dental University, Tokyo, Japan
  • Shiro Suzuki - Tokyo Medical and Dental University, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1767

doi: 10.3205/19ifssh0117, urn:nbn:de:0183-19ifssh01179

Veröffentlicht: 6. Februar 2020

© 2020 Shimura et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare, high-energy injury because of the strong capsulo-ligamentous complex structure. There are a few reports of this injury in the literature, and its optimal treatment remains controversial. This study aimed to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex.

Methods: Six patients with a mean age of 42.7 years (range, 30-56 years) treated for the thumb CMC joint were reviewed retrospectively. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score.

Results and Conclusions: The mean radial abduction of the thumb CMC joint was 61°, and the volar abduction was 59°. The mean Q-DASH-JSSH score was 4.0 (range, 0-15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction of the thumb CMC joint was observed in five patients at the final follow-up. However, in a rugby football player, we found subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury while playing rugby. In this patient, anatomical reduction was observed at 6 months of follow-up. Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for unstable dislocation of the thumb CMC joint.