title: Modified total trapezial and partial trapezoidal excision and ligament reconstruction tendon interposition reduces symptoms in isolated scaphotrapezial-trapezoid arthritis of the wrist.
abstract: Trapezial excision arthroplasty with ligament reconstruction and tendon interposition (LRTI) modified to include proximal trapezoid excision was performed on 12 wrists in 10 patients with symptomatic, isolated scaphotrapezial-trapezoid (STT) arthritis. Wrist range of motion, lateral pinch and grip strength, and analog pain scores were measured pre- and post-operatively. Mean follow-up was 18 (11-42) months. Post-operatively, reported pain scores uniformly decreased (p < 0.0001). Mean range of wrist flexion increased from 48 to 53° (p < 0.05) and extension from 51 to 55° (p < 0.05). There was also an overall increase in mean grip strength from 15.6 to 19.2 kg and pinch strength from 3.5 to 4.3 kg. Modified Mayo Wrist Scores were excellent in six cases, good in three, and fair in one. Our results suggest that modified total trapezial, partial trapezoidal excision and LRTI could be an effective surgical alternative in cases of isolated STT arthritis.
authors.affiliation: Lenox Hill Hospital, Department of Orthopedic Surgery, Division of Hand Surgery, New York, New York, USA.
authors.forename: J
authors.initials: J
authors.lastname: Andrachuk
authors.forename: S S
authors.initials: SS
authors.lastname: Yang
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011859:Radiography; D016059:Range of Motion, Articular; D013710:Tendons / Q000000981:diagnostic imaging / Q000601:surgery*; D051223:Trapezoid Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*