Description and outcomes of a new technique for thumb Basal joint arthroplasty.
OBJECTIVE
Many surgeries have been described for thumb basal joint arthroplasty, but none is clearly superior to the others. The purposes of this study were to describe a simple technique for trapeziectomy and ligament reconstruction, and to determine its objective and subjective outcomes.


METHODS
The surgical technique involves trapeziectomy, interposition of tissue, and abductor pollicis longus ligament reconstruction around the extensor carpi radialis longus tendon through a single incision. A retrospective chart review was performed on 48 patients who had undergone this surgery over an 11-year period by a single surgeon.


RESULTS
At a minimum of 8 months' follow-up, grip had improved from 71% of contralateral strength to 93% of contralateral strength (p = .02), an increase of 32%. Appositional pinch had improved from 66% of contralateral strength to 98% of contralateral strength (p = .03), an increase of 49%. Radial abduction did not change to a statistically significant degree. Trapezial space ratio measured 0.44 preoperatively and 0.31 postoperatively (p < .01), a decrease of 30%. Of 42 patients, 27 had little or no pain and an additional 11 had improved pain postoperatively. Of 41 patients, 26 were very or extremely satisfied and 13 were satisfied with the outcome of the surgery.


CONCLUSIONS
The described technique for trapeziectomy and ligament reconstruction is easy to perform, has a number of potential advantages over other arthroplasty techniques, and has similar short-term outcomes compared with ligament reconstruction and tendon interposition.
Sammer
Douglas M
DM
Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Amadio
Peter C
PC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050806:Arthroplasty, Replacement, Finger / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000503:physiopathology; D011474:Prosthesis Design; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013933:Thumb / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult