[Ligament reconstruction for trapeziometacarpal joint instability].

OBJECTIVE

Restoring stability and preventing subluxation/dislocation of the trapeziometacarpal (first carpometacarpal = CMC-I) joint while preserving mobility.

INDICATIONS: Posttraumatic, acquired or congenital instability of the CMC-I joint.

CONTRAINDICATIONS: Existence of osteoarthritis of the CMC-I joint. Neurogenic or muscular origin dysfunction of thenar muscles and other contractures the CMC-I area. Infections.

SURGICAL TECHNIQUE: Radiopalmar approach to the CMC-I joint, reduction, and transosseous ligament reconstruction with a distally pedicled tendon strip from the abductor pollicis longus muscle.

POSTOPERATIVE MANAGEMENT: Splint immobilization for 5 weeks.

RESULTS

This procedure generally results in good or very good outcomes. Of 24 patients, only one patient experienced rupture of the ligament reconstruction. Ligament reconstruction for the carpometacarpal joint of the thumb relieves pain and restores stability while preserving functional range of motion in patients with chronic instability.