A Novel Surgical Reconstruction Technique in the Management of Chronic Ulnar Collateral Ligament Tears with Volar Subluxation

Background: We hypothesized that ulnar collateral ligament reconstruction is inadequate for metacarpophalangeal joint stabilization in chronic ulnar collateral ligament injuries with volar subluxation due to dorsal joint capsule injury. We consecutively performed both ulnar collateral ligament and dorsal joint capsule reconstruction to treat patients with a chronic ulnar collateral ligament tear with volar subluxation. This study aimed to present our preliminary results and experience with this technique in managing such cases. Materials and Methods: In this retrospective study, 7 patients (6 males, 1 female) who underwent surgical reconstruction of both ulnar collateral ligament and dorsal joint capsule reconstruction for the treatment of chronic ulnar collateral ligament injuries with volar subluxation were included. The mean age was 31 (range = 20-39) years, and the mean follow-up was 15.5 (range = 12-20) months. Several clinical and radiological data were recorded. Results: The mean Visual Analogue Scale score significantly improved from 5.7 (range = 5-8) to 0.57 (range = 0-1) (P < .001). The mean quick- Disabilities of the Arm, Shoulder and Hand was significantly improved from 31.8 (range = 27.3-38.6) preoperatively to 3.2 (range = 0-6.8) at the final follow-up (P < .001). The mean preoperative extension deficit decreased from 18.5° (range = 10°-25°) to 0° (range= 0°-0°) at the final follow-up (P = .022). The mean preoperative flexion deficit increased from 10.7° (range = 0°-20°) to 31.4° (range = 25°-35°) postoperatively (P = 0.034). The mean key-pinch strength significantly increased from 33.2% (range = 27-37) preoperatively to 10.2% (range = 6-14) at the final follow-up assessment (P < .001). The mean hand grip strength significantly increased from 18.8% (range = 15-23) preoperatively to 6.4% (range = 6-14) at the final follow-up assessment (P < .001). Conclusion: With encouraging short-term clinical outcomes and a lower complication rate, surgical reconstruction of both ulnar collateral ligament and dorsal joint capsule seems to be a safe and effective surgical technique in the management of chronic ulnar collateral ligament tears with volar subluxation.