Efficacy of a radial-based thumb metacarpophalangeal-stabilizing orthosis for protecting the thumb metacarpophalangeal joint ulnar collateral ligament.
Joseph A Gil, Kerry Ebert, Keri Blanchard and 3 others
PMID 28711411WHAT IT FOUND
In ten cadaveric hands, a low-profile thumb orthosis that leaves the thumb tip and base free reduced thumb joint opening under sideways loads up to 100 N.
It does not prove earlier safe return to sport.
Key findings
01The low-profile orthosis reduced mean thumb MCP abduction at each applied load.
02The reported reductions in abduction angle were 41% at 20 N, 35% at 40 N, 31% at 60 N, 30% at 80 N, and 25% at 100 N.
03No ligament failures occurred in either the control or immobilized groups.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a cadaveric mechanical test, not a clinical trial, so it does not show how patients with thumb UCL injuries heal, feel, or return to activity. Only ten cadaveric hands were tested, and the paper does not report patient outcomes. The model forced abduction in one plane, and repeated loading could have stretched the ligament, although the authors used a 100 N preload to minimise this effect. The maximum tested force was 100 N, and the authors state that further work is needed to determine how abduction angle corresponds to actual UCL strain. The cadaveric model does not account for strength gained during ligament healing. The paper does not state whether the before and after loading order was randomised.
The easy way to misread this
Do not conclude that this orthosis safely allows athletes to return to sport after thumb UCL repair. The study tested ten cadaveric hands and measured thumb joint opening under applied loads. It did not test living patients, healing ligaments, pain, function, or sport participation.