Arch Hand Microsurg.  2018 Mar;23(1):12-19. 10.12790/ahm.2018.23.1.12.

Partial Trapeziectomy and Suture-Button Suspensionplasty for the Treatment of Thumb Carpometacarpal Joint Arthritis

• Kim D
• Park JW
• Park JH
• Choi IC

• KMID: 2412486
• DOI: http://doi.org/10.12790/ahm.2018.23.1.12

Abstract

PURPOSE
Our goal was to investigate the clinical results of partial trapeziectomy and suspensionplasty with suture button for the thumb basal joint osteoarthritis.
METHODS
A prospective study was performed for patients who have been undergone partial trapeziectomy and suspensionplasty by a suture button fixation for Eaton stage II or III osteoarthritis. Clinical outcome measures included visual analogue scale (VAS) for pain, Quick disabilities of the arm, shoulder, and hand (DASH), pinch and grip power, and thumb movement. Radiographic measurements and complication were recorded. A p-value < 0.05 was considered statistically significant.
RESULTS
Total number of the patients was nine, which included 8 females and 1 male. Average age at the time of surgery was 61.2±5.1 years old, and average duration of the follow-up period was 19 months (6-46 months). This procedure was carried out for dominant hand in 6 cases and non-dominant hand in 3 cases. In the early clinical outcomes at the postoperative 10 weeks, VAS measurement demonstrated statistically significant difference. Other clinical parameters; however, did not show as statistical significance at the postoperative 10 weeks. In addition, there was statistical significance in VAS, Quick DASH, grip and thumb range of motion, except pinch power at the last follow-up day. Serial radiographic change was shown during total follow-up period.
CONCLUSION
Partial trapeziectomy and suspensionplasty using suture button revealed improved clinical outcomes and return to early daily activity by permitting early thumb motion. So this surgical procedure can be a good option for thumb basal joint osteoarthritis.

Keyword

Thumb basal joint; Osteoarthritis; Partial trapeziectomy; Suspensionplasty; Suture button

MeSH Terms

Arm
Arthritis*
Carpometacarpal Joints*
Female
Follow-Up Studies
Hand
Hand Strength
Humans
Joints
Male
Osteoarthritis
Outcome Assessment (Health Care)
Prospective Studies
Range of Motion, Articular
Shoulder
Sutures
Thumb*

Figure

• 

  Fig. 1 (A) Skin incision is carried out over thumb basal joint, and then only the distal “horns” of the trapezial saddle and any peripheral osteophytes is resected. (B) K-wire was introduced through the first and second metacarpal bone as a proper positioning of the thumb, (C) First generation TightRope (Arthrex, Naples, FL, USA) is disassembled. (D) Bone tunnel is made using a 1.2 mm K-wire. (E) The TightRope is reassembled from the second metacarpal. (F) After the procedure, short arm thumb spica splint is applied lastly.

• 

  Fig. 2 (A) Eaton stage II arthritic change at the thumb basal joint is identified on plain radiograph (arrow), (B) immediate postoperative plain radiograph, (C) thumb movement at postoperative 10 weeks, (D) plain radiograph at postoperative 3 years, (E) full thumb motion was noted as much as contralateral side at postoperative 3 years.

• 

  Fig. 3 (A) Immediate postoperative hand plain radiograph, but implant irritation was noted, finally implant removal was carried out at postoperative 1 year. (B) There was no significant subsidence on plain radiograph at postoperative 4 months after implant removal.

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