A modified technique of interpositional arthroplasty in treating the Basal joint arthritis of the thumb in a Chinese population.
We performed a retrospective review of 22 thumbs in 22 Chinese patients attending for the basal joint arthritis of the thumb over the last 14 years. There were 16 women and six men with a mean age of 50 years old. All were treated surgically by partial trapeziectomy and volar oblique ligament reconstruction with flexor carpi radialis tendon and interpositional arthroplasty with a free palmaris longus tendon ball after failure of conservative treatment. The mean follow-up time was 48 months. Radiographs did not show any differences in the arthroplasty space index, arthroplasty space, trapezial space ratio and scaphoid-thumb metacarpal distance at the pre-operative evaluation and at the final follow-up evaluation. There was significant difference in the pain score, grip strength, Kapandji score and functional status before and after surgery at final follow-up period. One patient had complex regional pain syndrome which was resolved after receiving a course of anti-inflammatory drugs and physiotherapy. The authors suggest that the modified technique of partial trapeziectomy with tendon interpositional arthroplasty is a safe and effective method in treating basal joint arthritis of the thumb with good short term functional and radiological outcomes and minimal complication.
Department of Orthopaedics and Traumatology, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China. tedwong2@i-cable.com
Tak-Chuen
TC
Wong
Fu-Keung
FK
Ip
D000328:Adult; D001178:Arthroplasty / Q000379:methods*; D052737:Carpometacarpal Joints / Q000601:surgery*; D002681:China; D005260:Female; D018737:Hand Strength; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D012189:Retrospective Studies; D013709:Tendon Transfer; D013710:Tendons / Q000637:transplantation; D013933:Thumb / Q000601:surgery*; D051222:Trapezium Bone / Q000601:surgery