Jongen Isabel C, Nieuwdorp Niek J, Hundepool Caroline A, Van der Oest Mark J W, Moojen Thybout M, Selles Ruud W, Zuidam Jelle Michiel
Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands.
Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, the Netherlands.
J Hand Surg Am. 2025 Jul;50(7):885.e1-885.e8. doi: 10.1016/j.jhsa.2024.05.017. Epub 2024 Aug 2.
This study reviewed the results of the figure-of-eight ligament reconstruction, a technique used in the surgical management of thumb carpometacarpal (CMC) instability. This technique establishes joint stability through forces originating within the CMC joint, providing volar and dorsal support.
We evaluated the outcomes of 15 patients with nontraumatic, nonarthritic thumb CMC instability treated with the figure-of-eight ligament reconstruction technique. This technique involves routing a graft of the palmaris longus tendon through the base of the first metacarpal and trapezium bone in a figure-of-eight fashion. Preoperative visual analog scale (0-100) for pain and Michigan Hand Outcomes Questionnaire total scores were compared with 3- and 12-month postoperative scores. Secondary outcomes included strength, range of motion, patient satisfaction, return to work, and complications.
A significant improvement between intake and 12 months after surgery was observed for both Michigan Hand Outcomes Questionnaire total scores (53, SD 3 vs 70, SD 4) and visual analog scale pain scores (63, SD 4 vs 36, SD 7). Additionally, after surgery, restored thumb CMC joint stability was reported for all patients. Strength and range of motion improved between intake and 12 months after surgery. The median return to work was 6 weeks. Nine (60%) patients rated their satisfaction as "excellent" or "good," and 11 (73%) patients said that they would undergo the surgery again.
The figure-of-eight ligament reconstruction significantly improves pain and function in patients with thumb CMC instability while restoring joint stability and preserving range of motion, making it a suitable technique.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
本研究回顾了8字韧带重建术的结果，该技术用于拇指腕掌关节（CMC）不稳定的手术治疗。此技术通过源自CMC关节内的力量建立关节稳定性，提供掌侧和背侧支撑。
我们评估了15例非创伤性、非关节炎性拇指CMC不稳定患者采用8字韧带重建技术治疗的结果。该技术包括将掌长肌腱移植物以8字方式穿过第一掌骨基部和大多角骨。将术前疼痛视觉模拟量表（0 - 100）和密歇根手功能结果问卷总分与术后3个月和12个月的分数进行比较。次要结果包括力量、活动范围、患者满意度、恢复工作情况和并发症。
密歇根手功能结果问卷总分（53，标准差3对70，标准差4）和视觉模拟量表疼痛评分（63，标准差4对36，标准差7）在术前至术后12个月均有显著改善。此外，术后所有患者均报告拇指CMC关节稳定性恢复。术前至术后12个月力量和活动范围有所改善。恢复工作的中位时间为6周。9例（60%）患者将其满意度评为“优秀”或“良好”，11例（73%）患者表示愿意再次接受该手术。
8字韧带重建术可显著改善拇指CMC不稳定患者的疼痛和功能，同时恢复关节稳定性并保留活动范围，使其成为一种合适的技术。
研究类型/证据水平：治疗性IV级。
