Trapeziectomy

BACKGROUND: Suture-button fixation is an alternative to no fixation, first metacarpal distraction techniques, or Kirschner wire fixation after trapeziectomy in treatment of first carpometacarpal (CMC) arthritis. A 4-strand suture-button construct requires a 2.7-mm tunnel, whereas a 2-strand construct requires a 1.1-mm tunnel, potentially decreasing the risk of metacarpal fracture. We compared stability and failure criteria of 4-strand versus 2-strand construct in a biomechanical model of first CMC joint arthroplasty...

Introduction: Trapeziometacarpal arthritis is a common and disabling condition. There is no evidence in the literature of superiority of one surgical procedure over others. Several prosthetic implants have been introduced to preserve joint mobility. Sourced of data: We searched the on Medline (PubMed), Web of Science and Scopus databases using the combined keywords 'artelon', 'thumb', 'carpometacarpal', 'trapeziometacarpal' and 'rhizoarthrosis'; 11 studies were identified...

Trapeziectomy alone or in combination with a suspensionplasty technique is a common surgical treatment for symptomatic thumb basal joint arthritis. The authors undertook a prospective comparative study to test the hypothesis that peripheral nerve blocks would provide better pain control than local anesthesia with bupivacaine or liposomal bupivacaine regarding pain scores and opioid pill consumption. Patients who elected to undergo basal joint arthroplasty were allocated to 1 of 3 postoperative pain management groups: (1) peripheral nerve block, (2) local anesthesia with bupivacaine, or (3) local anesthesia with liposomal bupivacaine...

BACKGROUND: Trapeziectomy with ligament reconstruction tendon interposition (LRTI) or suspensionplasty is an effective treatment in older patients with end-stage thumb basilar arthritis. However, the survivability of this procedure is unknown in younger patients who may impart more stress on their thumbs. METHODS: A retrospective review was performed on all patients who underwent trapeziectomy and LRTI or suspensionplasty at 55 years of age or younger from 1992 to 2008...

Numerous arthroplasty techniques had been reported for the treatment of thumb carpometacarpal (CMC) joint osteoarthritis. The purpose of our study is to evaluate long-term clinical and radiographic outcomes of patients who underwent modified trapeziectomy with ligament reconstruction tendon interposition (LRTI).Our retrospective study included 20 consecutive patients with advanced thumb CMC arthritis receiving modified trapeziectomy with LRTI (20 thumbs). For clinical evaluation, we assessed visual analogue scale (VAS), Disabilities of the Arm, Shoulder and Hand (DASH) scores and Kapandji index...

BACKGROUND: The purpose of this investigation is to compare the radiographic and intraoperative assessment of scaphotrapezoid (ST) joint arthritis in patients with end-stage carpometacarpal (CMC) arthritis of the thumb base. We aim to define the incidence of ST arthritis in this population and determine whether radiographic features such as lunate morphology, dorsal intercalated segment instability (DISI), and scapholunate (SL) diastasis are associated with the incidence of ST arthritis...

BACKGROUNDS: The goal of this study was to compare trapeziectomy alone to trapeziectomy associated with a technique of suspensionplasty using the abductor pollicis longus with a minimum of 6 years of follow-up in the treatment of osteoarthritis of the first carpometacarpal joint. METHODS: Our series included 46 trapeziectomies in 35 patients, aged 69 years in average, among which 27 were women. In 27 cases group I, a trapeziectomy alone was performed, and in 19 cases group II, a trapeziectomy associated with an abductor pollicis longus suspensionplasty was performed...

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BACKGROUND: Trapeziectomy is one of the most painful procedures in ambulatory surgery. This prospective randomized trial aimed to compare postoperative pain control using distal peripheral nerve blocks (dPNB) with a low concentration of a long-acting local anaesthetic versus conventional systemic analgesia. METHODS: Fifty-two patients undergoing trapeziectomy were randomized to receive levobupivacaine 0.125% 5ml on radial and median nerves at the elbow (dNB group), or not to receive these blocks (control group)...

RATIONALE: Thumb carpometacarpal (CMC) arthritis is a common disease. Various procedures have been described for the treatment of advanced thumb CMC arthritis. This essay shows a CMC arthritis case treated by modified trapeziectomy with ligament reconstruction tendon interposition (LRTI). PATIENT CONCERNS: A 53-year-old Chinese female complained of pain and swelling at the base of the left thumb for 10 years. Visual analog scale (VAS) for thumb was 7 points, Disabilities of Arm, Shoulder and Hand (DASH) score was 51 points, and Kapandji score was 6 points before surgery...

The purpose of this study was to describe long-term outcomes of partial trapeziectomy with capsular interposition (PTCI) arthroplasty for patients with osteoarthritis of the basal joint of the thumb. A total of 27 patients (20 women, 7 men; 32 thumbs) with a mean age of 61 years (range, 47-74 years) agreed to return for follow-up and were included in the study. Mean postoperative follow-up was 64.3 months (range, 28-112 months). Evaluation included tests for grip and pinch strength; range of motion of the metacarpophalangeal joint; measurement of the first web space; completion of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; visual analog scale (VAS) measurements; and radiographic examination of the hand...

PURPOSE: To determine if arthroscopic partial trapeziectomy (APT) and soft tissue interposition arthroplasty is an effective treatment for symptomatic trapeziometacarpal arthritis. METHODS: We retrospectively evaluated 30 consecutive patients with symptomatic isolated trapeziometacarpal arthritis, Eaton-Littler stages II and III. Treatment consisted of an APT with soft tissue interposition utilizing an acellular dermal matrix as the interposition material. At a minimum of 6 months and 5 years after surgery, Numeric Pain Rating Scale (NPRS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), grip strength, oppositional and appositional pinch strengths, arthroplasty space, and thumb range of motion (ROM) were evaluated...

BACKGROUND: Thumb carpometacarpal joint arthroplasty for osteoarthritis may hold advantages over trapeziectomy by preserving range of motion, whilst providing stability and preventing thumb shortening. METHODS: We compare functional and satisfaction outcomes scores, radiological shortening and complication rates between patients treated with trapeziectomy and those receiving the ARPE thumb CMCJ arthroplasty. RESULTS: Seventy-five trapeziectomies and one hundred and ten ARPE arthroplasties were performed over the study period...

The thumb carpometacarpal joint (CMCJ1) is born to have good freedom of motion. However, the excellent mobility at this joint also predisposes attenuation of capsuloligamentous structures, joint incongruity, instability, and osteoarthritis. The prevalence of radiographic CMCJ1 arthritis is high. There is no single ideal surgery for all stages of CMCJ1 arthritis, and for all kinds of patients. The arthroscopic approach seems to provide a better alternative with rewarding preliminary results. It includes arthroscopic synovectomy/debridement/thermal shrinkage, arthroscopic partial trapeziectomy and suture button suspensionplasty, and arthroscopic CMCJ1 excision/suture button suspensionplasty/K-wire fixation...

The poly-L/D-lactide joint scaffold (RegJoint™) has recently been associated with adverse tissue reactions and osteolysis after partial trapeziectomy for trapeziometacarpal osteoarthritis. Twenty-two of 23 patients previously operated on with this scaffold were re-examined at a mean follow-up of 3.3 years (range 36-53 months). Overall, the results showed an unacceptably high rate of adverse tissue reactions related to the degradation process of the implant, resulting in a revision procedure in three patients...

PURPOSE: The objective of this randomized controlled trial was to compare the 12-month postoperative Michigan Hand Outcomes Questionnaire (MHQ) total score between patients with osteoarthritis (OA) at the first carpometacarpal (CMC I) joint who underwent trapeziectomy with suspension-interposition arthroplasty using the flexor carpi radialis (FCR) tendon and those receiving a human dermal collagen template (allograft). METHODS: We included 60 patients with CMC I OA who met the indications for surgery...

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BACKGROUND: The incidence of wrong-bone excision in hand surgery is not known. The wrist offers a unique challenge in that a single surgical incision yields access to multiple potential surgical sites, thus rendering site marking less effective. Mistaken identification of structures in the wrist is a real and potentially troublesome phenomenon. This study is designed to evaluate the occurrence of wrong-bone excision and to identify any risk factors and preventative measures that may help to prevent this complication in the future...

BACKGROUND: The purpose of this study was to evaluate current surgical practice patterns, the factors that influence these patterns, and overall trends in the treatment of thumb carpometacarpal osteoarthritis. METHODS: An online survey containing 14 questions was sent to all active members of the American Society for Surgery of the Hand. Information on demographics and treatments was collected. Results were anonymously uploaded to an online spreadsheet. RESULTS: A total of 823 responses were recorded...

BACKGROUND/PURPOSE: An improvement of the blood flow would be beneficial in microvascular upper-extremity reconstruction and in digit replantation. In the present work, skin perfusion changes and their duration due to axillary plexus block were quantified. METHODS: The peripheral blood flow of the upper extremities in 20 patients undergoing trapeziectomy under axillary plexus block was analyzed. RESULTS: Laser Doppler spectrophotometry was used to measure perfusion factors over a 12-h period, with the contralateral hand acting as the control...