The role of soft tissue reconstruction in flexible implant arthroplasty of the metacarpophalangeal joint.

In 116 hand metacarpophalangeal joint arthroplasties of the flexible type, the operative technique did not include reconstruction of capsular or ligamentous structures, but employed meticulous relocation of the common extensor tendons, and a modification of the metacarpal osteotomy plane and shape. A closely supervised program of splintage and therapy was instituted postoperatively. This series does not vary significantly with respect to range of motion or recurrence of ulnar drift (seen only when patients failed to wear splints as directed) in comparison to other reports. The results, therefore, fail to support the concept that radial capsular and ligamentous reconstruction is an essential part of this procedure.