Ligament reconstruction of the Trapezial-metacarpal joint for early arthritis: a preliminary report.
OBJECTIVE
To evaluate the results and determine the efficacy of an alternative ligament reconstruction technique in patients with a symptomatic trapezial-metacarpal joint associated with subluxation and early or limited chondral damage.


METHODS
This retrospective, nonrandomized study was composed of 6 patients, all women with ages between 31-46 years, treated by arthroscopic evaluation and reconstruction of the intermetacarpal and reverse anterior oblique ligament of the trapezial-metacarpal joint, using a strip of flexor carpi radialis tendon. Evaluation at an average follow-up of 18 months (range,12-28 mo) consisted of interview, examination, and computed tomography.


RESULTS
The visual analog pain score, preoperative rest pain, and activity pain improved significantly after surgery. Tip and lateral pinch strength measured 92% compared to the contralateral thumb, and computed tomography showed improved alignment of all joints.


CONCLUSIONS
Our results indicate that ligament reconstruction using the technique described reduced pain, increased strength, and improved the trapezial-metacarpal joint alignment in patients with early symptomatic trapezial-metacarpal joint osteoarthritis associated with joint subluxation.


METHODS
Therapeutic IV.
Victorian Hand Surgery Associates, St. Vincents Hand Clinic, Melbourne, Australia.
Philippa A
PA
Rust
Stephen K Y
SK
Tham
D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008023:Ligaments, Articular / Q000601:surgery*; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000000981:diagnostic imaging; D052581:Pinch Strength; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D013933:Thumb / Q000503:physiopathology / Q000601:surgery; D051222:Trapezium Bone / Q000601:surgery; D016896:Treatment Outcome