Anatomic Autograft Reconstruction of the Collateral Ligaments of the Thumb Metacarpophalangeal Joint

Chronic thumb collateral ligament injuries in the nonarthritic joint continue to pose treatment challenges. When acutely injured, ulnar and radial collateral ligaments can be primarily repaired. In the chronic setting, the injured ligaments can be difficult to mobilize and are, oftentimes, attenuated, exhibiting poor soft tissue quality. Chronic collateral ligament injuries are, therefore, typically reconstructed. There have been numerous proposed methods that are both static and dynamic in nature. We propose a simple technique that utilizes a free tendon graft that is passed through bone tunnels and restores the native ligamentous architecture. We do not require K-wire placement, external button fixation, or suture tape augmentation. The steps for this technique are highlighted in this article.