Jimenez Megan L, Hioe Stephen D, Kachooei Amir R, Shearin Jonathan W, Jones Christopher M, Rivlin Michael
1 Rowan University, Vineland, NJ, USA.
2 Rowan University, Stratford, NJ, USA.
Hand (N Y). 2019 Jul;14(4):483-486. doi: 10.1177/1558944717744338. Epub 2017 Dec 14.
The goal of this study is to compare the biomechanical properties of anatomic (double-bundle) versus single-bundle reconstruction of the thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) in a cadaveric model. Twelve fresh frozen cadaver hands were randomly assigned to single- or double-bundle reconstruction groups using a palmaris longus autograft and tenodesis screws. Two blinded examiners performed mechanical testing and measurements using fluoroscopic imaging. We evaluated MCP joint congruence and angle in the coronal plane at 0°, 30°, and 60° of flexion with valgus loads of 1.36 and 2.72 kg. Maximum MCP flexion and extension with a 0.45 kg load was also measured. There was no significant difference between single- versus double-bundle reconstruction in ulnar congruence or MCP angle. With varying amounts of flexion, there was no significant difference in MCP valgus angle between the 2 techniques, suggesting comparable joint congruity and coronal MCP angle along the arc of thumb MCP motion. Single- and double-bundle UCL reconstructions of the thumb MCP joint have comparable biomechanical properties in regard to joint congruity under valgus load.
本研究的目的是在尸体模型中比较拇指掌指（MCP）关节尺侧副韧带（UCL）解剖学（双束）重建与单束重建的生物力学特性。使用掌长肌自体移植物和张力带螺钉将12只新鲜冷冻尸体手随机分配到单束或双束重建组。两名不知情的检查者使用荧光透视成像进行力学测试和测量。我们在0°、30°和60°屈曲时，使用1.36和2.72 kg的外翻负荷评估MCP关节在冠状面的一致性和角度。还测量了0.45 kg负荷下的最大MCP屈曲和伸展。单束与双束重建在尺侧一致性或MCP角度方面无显著差异。随着屈曲程度的不同，两种技术之间的MCP外翻角度无显著差异，表明在拇指MCP运动弧上关节一致性和冠状面MCP角度相当。在外翻负荷下，拇指MCP关节的单束和双束UCL重建在关节一致性方面具有可比的生物力学特性。
