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Best Treatment for Grade III Thumb Ligament Tears

Radial collateral ligament (RCL) tears of the thumb are uncommon enough that the best treatment remains unknown. The authors of this study report the results of treatment for grade III RCL injuries in 26 patients. Surgical repair versus reconstruction was compared too.

Mild or moderate RCL tears rated as a I or II can be treated successfully with a cast or splint. Some doctors recommend using cast immobilization even for Grade III (complete) tears. Others believe complete tears must be repaired wit surgery.

In this study 26 patients were divided into two groups. One group had a repair of the thumb early on while the injury was still acute. The second group had reconstruction surgery much later -- usually years later.

Results were measured and compared using joint motion, grip and pinch strength, and joint stability. Patients in both groups had excellent or good results. Everyone reported being satisfied with the results.

The authors conclude it's best to repair grade III RCL injuries when they happen. Reconstruction months to years later should also be done. Repair or reconstruction should be done to prevent an unstable or arthritic thumb from developing.


Louis W. Catalano III, MD, et al. Results of Surgical Treatment of Acute and Chronic Grade II Tears of the Radial Collateral Ligament of the Thumb Metacarpophalangeal Joint. In The Journal of Hand Surgery. January 2006. Vol. 31A. No. 1. Pp. 68-75.

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