Arthroscopic Hemitrapeziectomy: Is an Internal Brace Worth It?

BACKGROUND: This article's purpose was to analyze clinical results obtained with thumb carpometacarpal (CMC) arthroscopic hemitrapeziectomy with temporary suspension with a Kirschner wire (K-wire).

METHODS: Seventy thumb CMC arthroscopic hemitrapeziectomies with a mean age of 59 and 18 months of follow-up were performed in our center during a 13-year period. All of them followed the same protocol. Surgical technique is described.

RESULTS: All patients were arthroscopically classified as Badia's III stage. No tendon interposition was used, and a K-wire was temporarily implanted for 5.1 weeks. Mean postsurgical Visual Analogue Scale of 1.6, Kapandji Opposition Score of 8.1, grip strength of 42.2 lbs, lateral pinch of 9.5 lbs, tip-to-tip pinch of 4.2 lbs and tripod pinch of 7.8 lbs were measured. All previous active workers resumed their previous job.

CONCLUSIONS: We conclude that thumb CMC arthroscopic hemitrapeziectomy with temporary suspension with K-wire reaches good results in terms of pain reduction, strength, and functionality, without the necessity of an internal brace which increases risks of a second metacarpal fracture.