Anterior oblique ligament reconstruction of the thumb using the transverse carpal ligament: description of a new procedure.

Abstract

Traumatic dislocation of the thumb carpometacarpal joint is an uncommon injury that may have long-term sequelae after treatment. Joint instability may cause pain, weakness of pinch, and the increased likelihood of development of posttraumatic arthritis. The anterior oblique ligament has generally been accepted as the most important static stabilizer of the trapeziometacarpal joint. Numerous operative techniques have been described to reconstruct this ligament. The author introduces a novel operative procedure to reconstruct the anterior oblique ligament of the thumb using the transverse carpal ligament (AOLR-T). This procedure was performed on 5 fresh-frozen cadaveric hands to assess its feasibility and potential efficacy. No technical difficulties were encountered. AOLR-T may be indicated for the treatment of thumb carpometacarpal instability of primary or secondary etiology and may avoid many of the disadvantages of traditional ligament reconstruction.