APB Transfer Stabilizes Chronic Thumb RCL
Case report describes return to activity and improved stability after tendon reconstruction
By
Andrea Surnit
April 6, 2026
Clinical Scorecard: APB Transfer Stabilizes Chronic Thumb RCL
At a Glance
Category Detail
Condition Chronic Radial Collateral Ligament Injury of the Thumb MCP Joint Key Mechanisms Modified abductor pollicis brevis tendon transfer for ligament reconstruction Target Population Patients with chronic RCL injuries, typically diagnosed late Care Setting Department of Hand Surgery and Microsurgery
Key Highlights
Improved stability and alignment in chronic RCL injuries No reported complications or radiographic failures at follow-up 20° reduction in MCP joint flexion compared to uninjured side Procedure performed under wide-awake local anesthesia Patients resumed daily activities within 3 months post-surgery Guideline-Based Recommendations
Diagnosis
Radiographs to assess for subluxation and joint stability Clinical examination for laxity and pain assessment Management
Reconstruction using modified APB tendon transfer Postoperative immobilization in a splint for 5 weeks Monitoring & Follow-up
Assess for stability and function at follow-up visits Monitor for signs of recurrent instability or degenerative changes Risks
Potential for postoperative loss of MCP joint flexion Risk of donor-site morbidity minimized with APB use Patient & Prescribing Data
Two male patients aged 58 and 66 years with chronic RCL injury
Modified APB tendon transfer offers a reliable alternative with functional outcomes
Clinical Best Practices
Utilize WALANT for patient comfort during surgery Ensure thorough assessment of RCL viability before reconstruction Initiate active motion of interphalangeal joint immediately post-surgery References
