Partial trapeziectomy with capsular interposition arthroplasty (PTCI): a novel technique for thumb basal joint arthritis.

INTRODUCTION: Osteoarthritis of the thumb trapeziometacarpal (basal) joint is a very common problem facing the hand and upper extremity surgeon. Many surgical procedures have been described with varied results. We present the surgical technique--partial trapeziectomy with capsular interposition arthroplasty--used by the senior author over the last 10 years. The essential steps of the procedure are: bony resection of the base of the first metacarpal and the distal trapezium; interposition of a proximally based joint capsule flap; and reefing of periosteal flaps elevated from the first metacarpal and including the abductor pollicis longus tendon. This procedure utilizes capsular tissue as an interposition without ligament reconstruction, eliminating the need for tendon harvest and the morbidity associated with the harvest. The postoperative rehabilitation is simple and can be done at home. An illustrative case is presented.

LEVEL OF EVIDENCE: Level V.