Radial Collateral Ligament (RCL) Reconstruction Thumb Metacarpo-Phalangeal Joint (MCP Joint)
Collateral ligaments are necessary for lateral stability of joints. They are particularly important in thumb metacarpo-phalangeal joints for stable pinch and grasp. Ulnar collateral ligament injuries of the thumb (gamekeeper or skier thumb) are more common than the radial side but both can cause significant disability. If any instability of the metacarpo-phalangeal joint is detected on the radial side of the joint with lateral stress and ulnar deviation than repair or reconstruction of the radial collateral ligament should be performed.
Photograph demonstrating the left thumb of a patient with a torn radial collateral ligament (RCL) of the metacarpi-phalangeal joint (MCP). There is tenderness and prominence on the dorsal radial aspect of the head of the thumb metacarpal.
The palmaris longus tendon graft has been used to reconstruct the RCL by passing it through two drill holes creating a cortical bridge at the radial base of the proximal phalanx and inserted into the dorsal radial aspect of the head of the metacarpal.