Jnl Wrist Surg 2018; 07(02): 156-159
DOI: 10.1055/s-0037-1604396
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Botox and Thumb MCP Radial Collateral Ligament Reconstruction

Robert A. Cates
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
Jeffrey S. Brault
2  Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota
Sanjeev Kakar
1  Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota
› Author Affiliations
Further Information

Publication History

09 December 2016

26 June 2017

Publication Date:
24 July 2017 (eFirst)


Background We report the use of botulinum toxin to aid in the treatment of chronic radial collateral ligament insufficiency of the thumb.

Case Description Treatment included autograft tendon reconstruction and cast immobilization. Six weeks postoperatively, prior to hand therapy, the patient underwent an ultrasound-guided botulinum neurotoxin A injection into the adductor pollicis muscle to negate its deforming forces on the reconstruction. The patient made an excellent recovery and 1 year postoperatively was pain free and had a stable radial collateral ligament (RCL) upon examination.

Literature Review The outcomes of RCL repair and reconstruction are unpredictable, in part, due to the strong opposing forces of the adductor pollicis.

Clinical Relevance The use of Botox injection may enhance the outcomes of RCL repair or reconstruction by neutralizing the deforming forces of the adductor muscle.