gms | German Medical Science

Objectives/Interrogation: Collateral ligament injuries of metacarpo-phalangeal joint are frequent in athletes expecially in ski and ball sports. Despite thumb collateral ulnar ligament injuries are well known, thumb collateral radial ligament and collateral ligament injuries of long fingers, may be sometimes underdiagnosed and thus can lead to chronic instability of metacarpo-pahlangeal joint. The aim of this study is to evaluate the results of the treated cases and recovery of work and sports activity.

Methods: In our Unit 110 patients were treated in five years, 45 of them were athletes (ski, basket, football, rugby, gymnastics). There were 32 ulnar thumb collateral ligament, 8 radial collateral ligaments (group I), 3 radial and 2 ulnar collateral ligaments of long fingers (Group II). There were four chronic cases in group I and one in group II. Mean age was 32 yo (17- 52), 31 males and 14 females. Dominant hand was involved in 39 patients. In acute injuries reinsertion with bone anchor or pull-out was performed while in chronic injuries reconstruction with a graft was performed. Thirty three patients were reviewed and at a mean follow up of 2 years (4-51months). Patients were assessed with VAS, DASH, Mayo score, measurement of pinch and grip, stability (grade I-III). Rehabilitation protocol was started after 3-5 weeks after surgery

Results: Stability was restored in all patients of group I, and in all but one patient of group II. GRIP was restored in 98% of thumbs and 88% of long fingers. Pinch was restored in 92% of thumbs and 75% of long fingers. According to Mayo Hand score there were in group I: 20 excellent, 5 good, 3 fair results. In group II there were 2 excellent, 2 good and 1 fair result. In group I mean VAS was 1, during sports was 2; in group II mean VAS was 0 and during sports was 1. Mean DASH was 10,9 (1,7- 29,3) in group I, and 6,7(0- 15,8) in group II. In Group I 94% of patients were satisfied with the treatment and 100% in group II. Slight residual stiffness of mean 10° of flexion (0-22°) was recorded in group I, none in group II. All patients returned to work and sports activities.

Conclusions: Stability can be restored with surgical treatment in the great majority of cases with restoration of grip and pinch strength despite a minimal lack of flexion with a recovery of previous work and sports activities.