Baskies Michael A, Tuckman David, Paksima Nader, Posner Martin A
Department of Orthopaedic Surgery, New York University-Hospital for Joint Diseases, New York, NY 10016, USA.
Am J Sports Med. 2007 Aug;35(8):1321-5. doi: 10.1177/0363546507303663. Epub 2007 Jun 15.
Several previous studies have described reconstructive methods for the treatment of an injury to the ulnar collateral ligament of the thumb. However, there are few biomechanical studies to date to analyze the strength of the surgical reconstruction.
To evaluate 2 reconstruction techniques with use of a cadaveric model: (1) reconstruction with the use of a free tendon graft placed in a figure-of-8 fashion through drill holes in the metacarpal and proximal phalanx of the thumb, and (2) reconstruction with the use of the Bio-Tenodesis Screw System.
Controlled laboratory study.
Eight matched pairs of cadaveric specimens underwent removal of the proper and accessory ulnar collateral ligaments. One of the 2 reconstruction methods was performed, and specimens were mounted on a materials-testing machine. The specimens were subjected to valgus stress to failure at 30 degrees of flexion. Failure was defined as valgus laxity of 30 degrees at the metacarpophalangeal joint.
The peak load to failure was 23.5 +/- 11.4 N for the figure-of-8 reconstruction and 24.3 +/- 12.3 N for the reconstruction using the Bio-Tenodesis Screw System. Comparing the 2 groups, there was no statistically significant difference in peak loads to failure (P = .88).
There was no statistically significant difference between the peak loads to failure of the 2 reconstructions.
The Bio-Tenodesis Screw System may provide another viable option for surgical reconstruction of the ulnar collateral ligament of the thumb.
此前已有多项研究描述了治疗拇指尺侧副韧带损伤的重建方法。然而，迄今为止，很少有生物力学研究来分析手术重建的强度。
使用尸体模型评估两种重建技术：（1）通过拇指掌骨和近节指骨上的钻孔以8字形方式置入游离肌腱移植物进行重建，以及（2）使用生物固定螺钉系统进行重建。
对照实验室研究。
八对匹配的尸体标本被切除固有和副尺侧副韧带。进行两种重建方法中的一种，然后将标本安装在材料试验机上。在30度屈曲位对标本施加外翻应力直至失效。失效定义为掌指关节处外翻松弛30度。
8字形重建的失效峰值载荷为23.5±11.4 N，使用生物固定螺钉系统重建的失效峰值载荷为24.3±12.3 N。比较两组，失效峰值载荷无统计学显著差异（P = 0.88）。
两种重建的失效峰值载荷之间无统计学显著差异。
生物固定螺钉系统可能为拇指尺侧副韧带的手术重建提供另一种可行选择。
