Dislocations and Ligament Injuries of the Hand-Thumb Ligament Injuries

Thumb Ligament Injuries

Pdf Summary

Thumb ligament injuries, particularly those involving the metacarpophalangeal joint, are common and require ongoing understanding and treatment. This article provides a comprehensive review of recent literature on the anatomy, function, diagnosis, and treatment of thumb ligament injuries. The thumb's extraordinary motion comes at the expense of stability, so the majority of stability in the MCP and TMC joints is provided by capsuloligamentous structures. The anatomy of the thumb ligaments is described, including the UCL, RCL, and AOL. The article discusses the importance of proper physical examination technique when evaluating thumb MCP ligament stability. Radiographs are routinely used to diagnose thumb ligament injuries, and MRI and ultrasound can also be used for diagnosis. The treatment of MCP ligament injuries is guided by joint stability, with grade 1 and 2 injuries typically treated with immobilization and grade 3 injuries treated with surgical repair or reconstruction. Chronic UCL and RCL tears can be treated with various reconstruction techniques, while acute TMC dislocations and fractures may require casting or surgical reconstruction. The article concludes by discussing different surgical options for the arthritic TMC joint, from synovectomy to arthrodesis. The review aims to provide clinicians with a deeper understanding of thumb ligament injuries and improve their diagnosis and treatment approaches.

Keywords

thumb ligament injuries

metacarpophalangeal joint

anatomy

diagnosis

treatment

physical examination technique

surgical repair

reconstruction

acute TMC dislocations

arthritic TMC joint