Thumb Ulnar Collateral Ligament (UCL) Repair
Thumb ulnar collateral ligament (UCL) repair is a surgical procedure performed to treat injuries or instability of the thumb's metacarpophalangeal joint (MCPJ). The UCL plays a crucial role in providing stability to the thumb during pinch grip activities, such as holding objects between the thumb and fingers, like using a key. When the UCL is injured or torn, it can lead to pain, weakness, and limited function of the thumb. UCL repair aims to restore strength and stability to the joint, allowing patients to regain full use of their thumb for functional hand movements.
Indications
Thumb UCL repair is indicated for individuals with the following conditions:
Acute injuries (skier’s thumb): Cases of recent, traumatic UCL tears or ruptures that result from sudden force or impact to the thumb. Classically called “skier’s thumb”, as the hand can get caught on the strap attached to ski poles, causing the thumb to get caught on the ski pole handle during a fall.
Chronic instability: Cases of chronic UCL instability due to repetitive stress or long-term wear and tear.
Functional hand movements, such as the pinch grip, heavily rely on the strength and stability of the thumb MCPJ. The UCL plays a critical role in maintaining the joint's stability during pinch grip activities, ensuring efficient grasp and manipulation of objects.
Technique
The technique for Thumb UCL repair may vary based on the nature and timing of the injury.
Acute cases: In cases of acute injuries, the UCL is repaired using specialised bone anchors reinforced with synthetic tape. These anchors secure the ligament back to its original position, providing stability to the MCPJ.
Chronic cases: In chronic cases where the UCL has been damaged beyond repair, a reconstruction procedure is required. The damaged UCL is replaced with a tendon graft taken from the patient's own wrist or, in some cases, from a donor source. The graft is meticulously placed to recreate the stability and function of the original UCL.
Post-surgery rehabilitation
Post-surgery rehabilitation is a crucial aspect of the recovery process and focuses on restoring strength and mobility to the thumb.
Immobilisation: Initially, the thumb may be immobilised with a splint or cast to protect the repaired UCL.
Gradual range-of-motion exercises: As healing progresses, gentle range-of-motion exercises are introduced to prevent stiffness and improve joint flexibility.
Strengthening exercises: Gradually, strengthening exercises are initiated to restore thumb stability and function.
Functional hand activities: As the thumb gains strength and stability, patients are encouraged to perform functional hand activities to regain full thumb functionality.
UCL ligament repair with Dr Oscar Brumby-Rendell
Thumb ulnar collateral ligament repair is a valuable surgical procedure for individuals with UCL instability or injuries that affect their ability to perform daily functional hand movements, like pinch grip. The procedure aims to restore thumb stability and strength, allowing patients to regain full use of their thumb for various activities. Post-surgery rehabilitation is a critical component of the recovery process, ensuring optimal outcomes and a return to functional hand movements. If you experience thumb pain, weakness, or instability, consult with Dr Oscar Brumby-Rendell to determine if thumb UCL repair is the appropriate treatment option for you.
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