Flexor Carpi Radialis Tendon Stabilization for Chronic First Carpometacarpal Joint Instability: Clinical Outcomes from a Case Report.

Abstract

Introduction: Chronic instability of the carpometacarpal (CMC) joint of the thumb can significantly impair hand function and cause persistent pain. Stabilising this joint is crucial for restoring function and alleviating discomfort. Utilising the flexor carpi radialis (FCR) tendon for stabilisation has shown promise due to its anatomical suitability and biomechanical properties.

Case report: A 20-year-old female patient presented with a complaint of non-traumatic popping of the metacarpophalangeal joint for the past 3 years. Conservative treatments, including splinting and physical therapy, were unsuccessful. Surgical stabilisation of the CMC joint with the FCR tendon was performed. The surgery was successful without intraoperative complications. Postoperative care involved immobilisation followed by a structured rehabilitation program. At 6 months and 1 year post-surgery, the patient experienced significant pain relief and improved thumb stability, with no recurrence of instability. Functional assessments indicated restored grip and pinch strength, assisting the patient to return to daily activities and work without limitations.

Conclusion: There was improvement in visual analogue scale score, disabilities of the arm, shoulder, and hand, and Kapandji score denoting better functional and pain outcome scores postoperatively. Using the FCR tendon with a suture anchor for CMC joint stabilisation in the thumb is an effective treatment for chronic instability, offering significant pain relief, enhanced stability, and restored hand function. This case supports the potential benefits of this surgical approach, though further research with larger cohorts is necessary to validate these findings.