Mark Mikhail, Nicholas Riley, Jeremy Rodrigues, Elaine Carr, Robin Horton, Nicholas Beale, David J Beard, Benjamin J F Dean, Lucy Clubb, Alan Johnstone, David Lawrie, Mohamed Imam, Sarah Joyce, Sudhi Ankarth, Rachel Capp, Kathryn Dayananda, Nick Gape, Ryan Trickett, Alice Bremner-Smith, Carol Chan, Rupert Eckersley, Maxim Horwitz, Anita Jatan, William Lumsdaine, Gordon McArthur, Sarah Mee, Louisa Banks, Sally Dean, Sasan Dehbozorgi, Kate Green, Sonu Meh, Francesca Fawkes, Jemma Rooker, Hannah Bell, Kalpesh Vaghela, Katia Fournier, Donna Kennedy, Lily Li, Suresh Srinivasan, David Gamble, Efstratios Gerakopoulos, Jordyn Groves, Thomas Jackson, Karthik Karuppaiah, Amy Maltby, Anjali Nair, Ines Reichert, Robert Bains, Chrishan Mariathas, Fiona Reilly, Laura Sharpe, Clare Wildin, Michael Feeney, Avadhut Kulkarni, Vikas Sharma, Sarah Flaherty, Anthony Gough, Katharine Hamlin, Lorraine King, Cherry Law, Simon Johnson, Cyndi Svee, Yasmeen Khan, Sarah Rodgers, Phil Storey, Ben Dean, Lizelle Sander-Danby, Karen Shields, Matthew Torkington, Rachel Blackshaw, Tahseen Chaudhry, Lisa Jordan, Feiran Wu, David Clarke, Elena Robinson, Ruben Thumbadoo, Miriam Parkinson, Kevin Sharpe, Matt Allen, Rob Poulter, Jamie Currie, Oliver Stone, Nicola Cliff, Andrew Duckworth, Alex Cowey, James Crossfield, Grey Giddins, Robyn Heath, Ilana Langdon, Lydia Mgbemena, Rebecca Mills, Greg Pickering, Mark Sheriff, Andrew McDonough, Zaf Naqui, Nicole Lyons, Emma Reay, Tracey Taylor, Michelle Bates, Gillian Eastwood, Iain McLoughlin-Symon, Ashwanth Ramesh, James Chan, Prashant Govilkar, Rebecca Shirley, Claire Upson, Soha Sajid, Elaine Carr, Claire Langley, Joanna Higgins, Alexander Armstrong, Sameer Gujral, Aimee Howe, Mina Ip, Janette Thornsby, Robert Slade, Laura Knowles, Stephen Lipscombe, Theresa Goggins, Sumedh Talwalkar
{"title":"The management of acute complete ruptures of the ulnar collateral ligament of the thumb.","authors":"Mark Mikhail, Nicholas Riley, Jeremy Rodrigues, Elaine Carr, Robin Horton, Nicholas Beale, David J Beard, Benjamin J F Dean, Lucy Clubb, Alan Johnstone, David Lawrie, Mohamed Imam, Sarah Joyce, Sudhi Ankarth, Rachel Capp, Kathryn Dayananda, Nick Gape, Ryan Trickett, Alice Bremner-Smith, Carol Chan, Rupert Eckersley, Maxim Horwitz, Anita Jatan, William Lumsdaine, Gordon McArthur, Sarah Mee, Louisa Banks, Sally Dean, Sasan Dehbozorgi, Kate Green, Sonu Meh, Francesca Fawkes, Jemma Rooker, Hannah Bell, Kalpesh Vaghela, Katia Fournier, Donna Kennedy, Lily Li, Suresh Srinivasan, David Gamble, Efstratios Gerakopoulos, Jordyn Groves, Thomas Jackson, Karthik Karuppaiah, Amy Maltby, Anjali Nair, Ines Reichert, Robert Bains, Chrishan Mariathas, Fiona Reilly, Laura Sharpe, Clare Wildin, Michael Feeney, Avadhut Kulkarni, Vikas Sharma, Sarah Flaherty, Anthony Gough, Katharine Hamlin, Lorraine King, Cherry Law, Simon Johnson, Cyndi Svee, Yasmeen Khan, Sarah Rodgers, Phil Storey, Ben Dean, Lizelle Sander-Danby, Karen Shields, Matthew Torkington, Rachel Blackshaw, Tahseen Chaudhry, Lisa Jordan, Feiran Wu, David Clarke, Elena Robinson, Ruben Thumbadoo, Miriam Parkinson, Kevin Sharpe, Matt Allen, Rob Poulter, Jamie Currie, Oliver Stone, Nicola Cliff, Andrew Duckworth, Alex Cowey, James Crossfield, Grey Giddins, Robyn Heath, Ilana Langdon, Lydia Mgbemena, Rebecca Mills, Greg Pickering, Mark Sheriff, Andrew McDonough, Zaf Naqui, Nicole Lyons, Emma Reay, Tracey Taylor, Michelle Bates, Gillian Eastwood, Iain McLoughlin-Symon, Ashwanth Ramesh, James Chan, Prashant Govilkar, Rebecca Shirley, Claire Upson, Soha Sajid, Elaine Carr, Claire Langley, Joanna Higgins, Alexander Armstrong, Sameer Gujral, Aimee Howe, Mina Ip, Janette Thornsby, Robert Slade, Laura Knowles, Stephen Lipscombe, Theresa Goggins, Sumedh Talwalkar","doi":"10.1302/2633-1462.58.BJO-2024-0062.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":34103,"journal":{"name":"Bone & Joint Open","volume":"5 8","pages":"708-714"},"PeriodicalIF":2.8000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11338659/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1302/2633-1462.58.BJO-2024-0062.R1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
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.
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