Application of tension band wire in the treatment of avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint

Objective To explore the treatment method and clinical efficacy of acute avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint. Methods From July 2014 to December 2017, 9 patients with acute avulsion fracture type radial collateral ligament injuries of thumb metacarpophalangeal joint were treated with tension band Kirschner wire and steel wire to fix avulsion bone fragments and reconstruct ligament insertion. The metacarpophalangeal joint was fixed at 15° of flexion. The thumb exercise was conducted 3 weeks postoperatively. Results All the 9 patients were follow-up for 6 to 28 months with an average of 15 months. The thumb metacarpophalangeal joint was stable and the interphalangeal joint had good movement and pinch strength. X-ray showed that all the avulsion fragments of the radial collateral ligament of proximal phalanx achieved bone healing, and the healing time was 4 to 6 weeks. According to the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the results were rated as excellent in 8 cases and good in 1 case. Conclusion Fixing avulsed fragments by tension band steel wire can reconstruct the radial collateral ligament insertion of thumb metacarpophalangeal joint with high stability. It is simple operation with satisfactory curative effect. Key words: Thumb; Fractures,bone; Metacarpophalangeal joint; Radial collateral ligament