The management of acute complete ruptures of the ulnar collateral ligament of the thumb.
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Authors
Mikhail, Mark
Riley, Nicholas
Rodrigues, Jeremy
Carr, Elaine
Horton, Robin
Beale, Nicholas
Beard, David J
Dean, Benjamin J F
Clubb, Lucy
Johnstone, Alan
Issue Date
2024-08-22
Type
Journal Article
Language
en
Keywords
Alternative Title
Abstract
Aims: Complete ruptures of the ulnar collateral ligament (UCL) of the thumb are a common injury, yet little is known about their current management in the UK. The objective of this study was to assess the way complete UCL ruptures are managed in the UK.
Methods: We carried out a multicentre, survey-based cross-sectional study in 37 UK centres over a 16-month period from June 2022 to September 2023. The survey results were analyzed descriptively.
Results: A total of 37 centres participated, of which nine were tertiary referral hand centres and 28 were district general hospitals. There was a total of 112 respondents (69 surgeons and 43 hand therapists). The strongest influence on the decision to offer surgery was the lack of a firm 'endpoint' to stressing the metacarpophalangeal joint (MCPJ) in either full extension or with the MCPJ in 30° of flexion. There was variability in whether additional imaging was used in managing acute UCL injuries, with 46% routinely using additional imaging while 54% did not. The use of a bone anchor was by far the most common surgical option for reconstructing an acute ligament avulsion (97%, n = 67) with a transosseous suture used by 3% (n = 2). The most common duration of immobilization for those managed conservatively was six weeks (58%, n = 65) and four weeks (30%, n = 34). Most surgeons (87%, n = 60) and hand therapists (95%, n = 41) would consider randomizing patients with complete UCL ruptures in a future clinical trial.
Conclusion: The management of complete UCL ruptures in the UK is highly variable in certain areas, and there is a willingness for clinical trials on this subject.
Description
© 2024 Mikhail et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
Citation
Mikhail, M.; Riley, N.; Rodrigues, J.; et al. 'The management of acute complete ruptures of the ulnar collateral ligament of the thumb', Bone & Joint Open. 2024;5(8) pp. 708-714. Available at: https://doi.org/10.1302/2633-1462.58.bjo-2024-0062.r1
Publisher
Bone & Joint
License
© 2024 Mikhail et al.
Journal
Bone & joint open
Volume
5
Issue
8
PubMed ID
ISSN
2633-1462