Thumb volar plate reconstruction utilizing extensor pollicis brevis autograft: evaluation of a new technique

Background: Sagittal plane instability of the thumb metacarpophalangeal joint is a difficult problem with numerous surgical techniques described. The purpose of the study is to demonstrate a technique in which a distally based extensor pollicis brevis tendon autograft is utilized to reconstruct the deficient volar plate. Methods: This is a retrospective case series of four patients who were followed a minimum of 2 years after this procedure. Patient demographics, return to work status, and objective outcomes are reported. Results: This technique compared favorably to those previously described, in terms of technical ease, functional results, and patient satisfaction. Each patient returned to his previous activity level and was maintained on active duty in his current military occupational specialty. None required a permanent profile to limit the physical demands of his job. Conclusions: Preliminary data suggests this technique is anatomically sound, technically less demanding, and requires minimal surgical dissection compared to previously described procedures.