Transosseous Suture Fixation of Avulsion Fracture of the Ulnar Collateral Ligament of the Thumb Metacarpophalangeal Joint

Acute traumatic avulsion or rupture of the ulnar collateral ligament (UCL) of the thumb metacarpophalangeal (TMP) joint is a frequent sports-related injury. If not diagnosed and treated early, it may lead to chronic instability, pain, and loss of pinch and grip strength and possibly osteoarthritis. UCL insufficiency may be treated by various techniques, such as bone anchors, transosseous sutures with or without a pull-out button, tendon grafts, or with TMP joint fusion in neglected cases with arthrosis. A simple technique of internal fixation of an avulsion fracture of the distal attachment of the UCL on the proximal phalanx of the thumb using transosseous sutures is described.