Author(s)

Haruhiko Shimura^1*, Tetsuya Sato², Akimoto Nimura³, Yoshiaki Wakabayashi⁴, Koji Fujita⁴

¹Department of Orthopedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
²Department of Orthopedic Surgery, Doai Memorial Hospital, Tokyo, Japan.
³Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
⁴Department of Orthopedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex. Materials and methods: Eight patients with a mean age of 39.8 years (range, 23 - 56 years) treated for the thumb CMC joint were treated in our hospital between 2008 and 2018. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score. Results: The mean radial abduction of the thumb CMC joint was 66°, and the volar abduction was 63°. The mean Q-DASH-JSSH score was 4.8 (range, 0 - 15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction was observed in seven patients at the final follow-up and in a rugby football player at 6 months of follow-up; however, subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury was observed. Conclusion: Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for acute unstable dislocation of the thumb CMC joint.

Thumb Carpometacarpal Joint, Dislocation, Dorsal Capsulo-Ligamentous Complex, Surgical Repair, Suture Anchors

Shimura, H. , Sato, T. , Nimura, A. , Wakabayashi, Y. and Fujita, K. (2019) Surgical Repair of Dorsal Capsulo-Ligamentous Complex for Dislocation of the Thumb Carpometacarpal Joint. Open Journal of Orthopedics, 9, 145-151. doi: 10.4236/ojo.2019.98015.