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Sexual dimorphism in the anatomy of the ulnar collateral thumb ligament

Zeitschrift:: Wiener klinische Wochenschrift

Autoren:: MD Martin F. Vierhapper, MD, PhD Gabriela K. Muschitz, MD Stefan Hacker, MD, PhD Sandra E. Boesmueller, MD, PhD Michael Pretterklieber, MD, PhD Hugo B. Kitzinger

Wichtige Hinweise

This work was presented at the annual meeting of the Austrian society of plastic and reconstructive surgery in October 2016 in Innsbruck

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Summary

Background

Treatment of ruptured ulnar collateral thumb metacarpophalangeal (MCP) joint ligaments (UCL) necessitate a profound anatomic knowledge for optimal surgical repair in order to preserve range of motion and ensure postoperative joint stability. Therefore, knowledge of the angle between the UCL and the longitudinal axis of the first metacarpal bone could be useful.

Methods

In this study 46 ulnar collateral thumb MCP joint ligaments in 15 male and 15 female embalmed anatomic specimens were dissected and the angles between the longitudinal axis of the first metacarpal bone and the proper (PUCL) as well as the accessory ulnar collateral thumb MCP ligament (AUCL) were measured.

Results

In male specimens the angle for the PUCL measured on average 133.5° (±2.35°) and 122.75° (±3.8°) for the AUCL. A significantly different angle was measured for female specimens which showed on average 137.88° (±3.51°) for the PUCL and 128.65° (±4.14°) for the AUCL.

Conclusions

Optimal surgical repair or reconstruction of torn ulnar collateral thumb MCP joint ligaments should aim for an angle of approximately 135° in PUCL and 126° in AUCL in relation to the longitudinal axis of the metacarpal bone. Differences in men and women should be considered if possible.

Level of evidence

IV (anatomic study).

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Fritsche E, De Monaco D, Drinkuth S, von Wartburg U. Simultaneous avulsion fracture of the insertion of the ulnar and radial collateral ligaments of the metacarpophalangeal joint of the thumb. Br J Plast Surg. 2000;53(2):168–70. CrossRef

Samora JB, Harris JD, Griesser MJ, Ruff ME, Awan HM. Outcomes after injury to the thumb ulnar collateral ligament—A systematic review. Clin J Sport Med. 2013;23(4):247–54. CrossRef

Bailie DS, Benson LS, Marymont JV. Proximal interphalangeal joint injuries of the hand. Part I: Anatomy and diagnosis. Am J Orthop. 1996;25(7):474–7. PubMed

Benson LS, Bailie DS. Proximal interphalangeal joint injuries of the hand. Part II: Treatment and complications. Am J Orthop. 1996;25(8):527–30. PubMed

Aldrian S, Valentin P, Wondrasch B, Krusche-Mandl I, Ostermann RC, Platzer P, et al. Gender differences following computer-navigated single- and double-bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):2145–52. CrossRef

Heyman P, Gelberman RH, Duncan K, Hipp JA. Injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Biomechanical and prospective clinical studies on the usefulness of valgus stress testing. Clin Orthop Relat Res. 1993;292:165–71. CrossRef

Minami A, An KN, Cooney WP 3rd, Linscheid RL, Chao EY. Ligamentous structures of the metacarpophalangeal joint: A quantitative anatomic study. J Orthop Res. 1984;1(4):361–8. CrossRef

Fraser B, Veitch J, Firoozbakhsh K. Assessment of rotational instability with disruption of the accessory collateral ligament of the thumb MCP joint: A biomechanical study. Hand. 2008;3(3):224–8. CrossRef

Carlson MG, Warner KK, Meyers KN, Hearns KA, Kok PL. Anatomy of the thumb metacarpophalangeal ulnar and radial collateral ligaments. J Hand Surg Am. 2012;37(10):2021–6. CrossRef

10.

Tsiouri C, Hayton MJ, Baratz M. Injury to the ulnar collateral ligament of the thumb. Hand. 2009;4(1):12–8. CrossRef

11.

Campbell CS. Gamekeeper’s thumb. J Bone Joint Surg Br. 1955; https://doi.org/10.1302/0301-620X.37B1.148. CrossRefPubMed

12.

Derkash RS, Matyas JR, Weaver JK, Oden RR, Kirk RE, Freeman JR, et al. Acute surgical repair of the skier’s thumb. Clin Orthop Relat Res. 1987;216:29–33.

13.

Kaplan SJ. The Stener lesion revisited: A case report. J Hand Surg Am. 1998;23(5):833–6. CrossRef

14.

Jones S, Crawford I. Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. Plaster or functional splint in gamekeepers thumb. Emerg Med J. 2002;19(4):324. CrossRef

15.

Crowley TP, Stevenson S, Taghizadeh R, Addison P, Milner RH. Early active mobilization following UCL repair with Mitek bone anchor. Tech Hand Up Extrem Surg. 2013;17(3):124–7. PubMed

16.

Gluck JS, Balutis EC, Glickel SZ. Thumb ligament injuries. J Hand Surg Am. 2015;40(4):835–42. CrossRef

17.

Smith RJ. Post-traumatic instability of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Am. 1977;59(1):14–21. CrossRef

18.

Bean CH, Tencer AF, Trumble TE. The effect of thumb metacarpophalangeal ulnar collateral ligament attachment site on joint range of motion: An in vitro study. J Hand Surg Am. 1999;24(2):283–7. CrossRef

19.

Baskies MA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bull NYU Hosp Jt Dis. 2009;67(1):68–74. PubMed

20.

Rhee PC, Jones DB, Kakar S. Management of thumb metacarpophalangeal ulnar collateral ligament injuries. J Bone Joint Surg Am. 2012;94(21):2005–12. CrossRef

21.

Carlson MG, Warner KK, Meyers KN, Hearns KA, Kok PL. Mechanics of an anatomical reconstruction for the thumb metacarpophalangeal collateral ligaments. J Hand Surg Am. 2013;38(1):117–23. CrossRef

22.

Lee SK, Kubiak EN, Lawler E, Iesaka K, Liporace FA, Green SM. Thumb metacarpophalangeal ulnar collateral ligament injuries: A biomechanical simulation study of four static reconstructions. J Hand Surg Am. 2005;30(5):1056–60. CrossRef

23.

Boesmueller S, Huf W, Rettl G, Dahm F, Meznik A, Muschitz G, et al. The influence of sex and trauma impact on the rupture site of the ulnar collateral ligament of the thumb. PLoS ONE. 2017;12(7):e181754. CrossRef

24.

Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: A comparison of Women’s National Basketball Association and National Basketball Association athletes. Am J Sports Med. 2006;34(7):1077–83. CrossRef

25.

Nordenvall R, Bahmanyar S, Adami J, Stenros C, Wredmark T, Fellander-Tsai L. A population-based nationwide study of cruciate ligament injury in Sweden, 2001–2009: Incidence, treatment, and sex differences. Am J Sports Med. 2012;40(8):1808–13. CrossRef

26.

Ito E, Iwamoto J, Azuma K, Matsumoto H. Sex-specific differences in injury types among basketball players. Open Access J Sports Med. 2015;6:1–6. PubMed

27.

Mountcastle SB, Posner M, Kragh JF Jr., Taylor DC. Gender differences in anterior cruciate ligament injury vary with activity: Epidemiology of anterior cruciate ligament injuries in a young, athletic population. Am J Sports Med. 2007;35(10):1635–42. CrossRef

28.

Bere T, Florenes TW, Nordsletten L, Bahr R. Sex differences in the risk of injury in World Cup alpine skiers: A 6-year cohort study. Br J Sports Med. 2014;48(1):36–40. CrossRef

Titel: Sexual dimorphism in the anatomy of the ulnar collateral thumb ligament
Autoren:: MD Martin F. Vierhapper
MD, PhD Gabriela K. Muschitz
MD Stefan Hacker
MD, PhD Sandra E. Boesmueller
MD, PhD Michael Pretterklieber
MD, PhD Hugo B. Kitzinger
Publikationsdatum: 01.04.2019
DOI: https://doi.org/10.1007/s00508-019-1483-8
Verlag: Springer Vienna
Zeitschrift: Wiener klinische Wochenschrift The Central European Journal of Medicine
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671

Springer Medizin Österreich