[Suspension arthroplasty of the thumb carpometacarpal joint: modified surgical technique, follow-up treatment and results--a retrospective analysis of 51 operations].
OBJECTIVE
A modified surgical technique using suspension arthroplasty against primary osteoarthritis of the thumb carpometacarpal joint was analysed.


METHODS
This retrospective analysis focused on 41 patients who underwent suspension arthroplasties with a modified technique between 1997-2005. With the help of this technique, a long-range preparation of the flexor carpi radialis tendon can be avoided. Only the ca. 3 cm of tendon which is visible in the site was split in half and cut off proximally. This half tendon was provided with a suture in baseball-stitch technique. It was then press-fit fixed with a suture in a sloping drill hole of the MC 1 basis. The patients required a cast for only 3 weeks postoperatively. Afterwards, they received an orthesis for 2-3 weeks with increasing mobilisation. The postoperative course was clinically and radiologically analysed. The results were analysed at 3 months and 1-7 years after surgery. All patients were operated as outpatients.


RESULTS
Of the 41 patients, 40 had a high subjective satisfaction. A total of 45 operations showed excellent results. There were no poor results. Only one patient would not undergo the surgery again. The radiological distance between metacarpal 1 and the distal scaphoid lay between 4 mm and 9 mm after 3 months and 1-7 years.


CONCLUSIONS
The described modification of suspension arthroplasty with a short-range mobilisation of the flexor carpi radialis tendon reduced the morbidity of preparation and led to stable suspension. Thus, immobilisation over 3 weeks was not necessary. Patients obtained good, early functional results.
Brand
J
J
Chirurgische Gemeinschaftspraxis Brand, Dyck, Schulz, Cellerstr 24, 29525, Uelzen, Germany. brand@branddyckschulz.de
Gaulke
R
R
Geerling
J
J
Meller
R
R
Krettek
C
C
D001178:Arthroplasty / Q000379:methods*; D052737:Carpometacarpal Joints / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D013536:Suture Techniques; D013709:Tendon Transfer / Q000379:methods*; D013710:Tendons / Q000601:surgery*; D013933:Thumb / Q000601:surgery*