Ligamentous reconstruction for the instability of the thumb CM joint using the extensor carpi radialis longus tendon.

概要

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Two concepts on the ligamentous stability of the first CM joint have been discussed. One of these is that emphasized on the anterior oblique carpometacarpal ligament by Eaton, in 1969. Another is the concept insisted by Pagalidis, in 1981 on the intermetacarpal ligaments. We attached great importance to the idea of Pagalidis. We tried to reconstruct the intermetacarpal ligaments with the ECRL tendon, rather than the FCR tendon because of it's ease to use.For past 12 years, we have performed this ligamentous reconstruction using the ECRL tendon on 6 patients.Except for one case whose instability of the CM joint resulted from trauma, causes of other cases were established by osteoarthritic changes.Four out of 6 cases, had Ashworth's surface replacement with ligamentous reconstructions, while two cases had only ligamentous reconstruction.After operation, all cases (except for one that was too early postoperatively to evaluate) achieved good results in stability and relief of pain.