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Dorsoradial Ligament Imbrication for Thumb Carpometacarpal Joint Instability

Birman, Michael V. MD*; Danoff, Jonathan R. MD; Yemul, Kiran S. BS; Lin, James D. MD, MS; Rosenwasser, Melvin P. MD

Techniques in Hand & Upper Extremity Surgery: June 2014 - Volume 18 - Issue 2 - p 66–71
doi: 10.1097/BTH.0000000000000035
Techniques

Dorsoradial ligament imbrication is a direct and effective alternative to ligament reconstruction or metacarpal osteotomy in patients with symptomatic thumb carpometacarpal (CMC) joint instability. This procedure is performed by imbricating either the trapezial or the metacarpal attachment of the dorsoradial ligament with the use of a suture anchor. The procedure is indicated in the setting of chronic hyperlaxity or instability of the thumb CMC joint. Significant arthritic changes in the thumb CMC joint are a contraindication for this procedure. We present our technique along with an anatomic dissection to demonstrate the ligament and surgical procedure on an anatomic specimen. We also present results from 3 patients who underwent this technique with images and clinical results for 3 patients with long-term follow-up.

Level of Evidence: Level IV—Therapeutic.

*Hand Surgery Associates SC, Arlington Heights, IL

Department of Orthopaedic Surgery, Trauma Training Center, Columbia University Medical Center, New York, NY

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Melvin P. Rosenwasser, MD, Robert E. Carroll Professor of Hand Surgery, Department of Orthopaedic Surgery, Columbia University College of Physicians & Surgeons, 622 West 168th Street, PH-1119, New York, NY 10032. E-mail: ttc@columbia.edu.

© 2014 by Lippincott Williams & Wilkins