Trapeziectomy and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for osteoarthritis of the trapeziometacarpal joint: surgical technique and long-term results.
OBJECTIVE
To report the long-term results of excision of the trapezium and intermetacarpal ligament reconstruction with the extensor carpi radialis longus for thumb trapeziometacarpal osteoarthritis.


METHODS
Fourteen women and 5 men were retrospectively reviewed after an average of 9 years of follow-up evaluation. Trapeziectomy was performed and the extensor carpi radialis longus was harvested by a dorsoradial approach to reconstruct the intermetacarpal ligament. All patients wore a below-elbow cast for 6 weeks. Each patient had objective and subjective assessments. Thumb shortening was measured in follow-up radiographs.


RESULTS
At the final follow-up evaluation, 16 (84%) patients were free of pain and 17 patients (89%) were satisfied with the results. Grip, key strength, and pinch strength improved compared with preoperative values. The trapezium space lost 14% of its height compared with preoperative values. Thumb motion improved, and there were no cases of instability.


CONCLUSIONS
Resection-arthroplasty of the trapezium with intermetacarpal ligament reconstruction with the extensor carpi radialis longus is an effective procedure that permits motion restoration and pain relief in the trapeziometacarpal joint in the long term without affecting thumb stability.


METHODS
Therapeutic IV.
Illarramendi
Aldo A
AA
Hand and Upper Extremity Department, Prof. Dr. Carlos Ottolenghi Institute, Italian Hospital of Buenos Aires, Buenos Aires, Argentina. aillarra@fibertel.com.ar
Boretto
Jorge G
JG
Gallucci
Gerardo L
GL
De Carli
Pablo
P
D000368:Aged; D050824:Carpal Joints / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D018737:Hand Strength; D006801:Humans; D017746:Joint Capsule / Q000601:surgery; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D050279:Metacarpal Bones / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D013709:Tendon Transfer / Q000379:methods*; D013933:Thumb / Q000000981:diagnostic imaging / Q000601:surgery; D051222:Trapezium Bone / Q000601:surgery*; D051223:Trapezoid Bone / Q000000981:diagnostic imaging / Q000601:surgery