[Total trapeziectomy with suspension and interposition tendinoplasty for trapeziometacarpal osteoarthrisis: results at 6.5 years average follow-up].

OBJECTIVES: Total trapeziectomy remains the main surgical treatment of trapeziometacarpal osteoarthritis. Little has been reported on the long-term results of this technique. We report in this study our experience with our technique of trapeziectomy associated with interposition and suspension tendinoplasty using the abductor pollicis longus tendon with 78 months average follow-up.

METHODS: Eighteen patients (22 thumbs) of 62.7 years average age underwent this procedure. According to Dell classification, there were two stage II, five stage III and 15 stage IV. Signs of osteoarthritis of the scaphotrapezoidal joint were associated in 19 cases.

RESULTS: At 78 months average follow-up, 73 % of the patients were painfree. Average opposition was 9.4 out of 10 according to Kapandji, the grip strength was equal to 18.5 kg and the key pinch to 4.4 kg. The quick DASH was equal to 20 over 100. Ninety-one percent of the patients were satisfied or very satisfied with the results. Space between scaphoïd and thumb metacarpal was 3.2mm and was down by 27 %. There were only two complications related to a reflex sympathetic dystrophy.

DISCUSSION AND CONCLUSION: Trapeziectomy associated with interposition and suspension tendinoplasty gives satisfactory functional results which are maintained with follow-up with high satisfaction rate and low complication rate.