Tendon interposition arthroplasty of the first carpo-metacarpal joint.
After removal of the trapezium, imbrication of abductor pollicis longus and fixing it with a strip of flexor carpi radialis tendon, we obtained a stable arthroplasty having three quarters of normal mobility and half to full power. Of the first 100 operated thumbs, 15 patients had slight pain on heavy use; the rest were painfree. Three patients had radial nerve lesions with minor complaints. Seven patients developed de Quervain's syndrome and two had rupture of abductor pollicis longus; these complications have since been avoided by routinely splitting the first extensor compartment. Four cases with unstable joints required further surgery, and one joint became stiff due to extra-articular conditions.
Weilby
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Handsurgical Unit, Rigshospitalet, Copenhagen.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D011183:Postoperative Complications; D013710:Tendons / Q000601:surgery*; D013933:Thumb / Q000601:surgery*; D014955:Wrist Joint / Q000601:surgery*