Abstract
Many different surgical procedures have been used to alleviate the pain of first carpometacarpal joint osteoarthritis. The most common procedure involves removal of the trapezium with, or without, suspension of the base of the first metacarpal. This operation may also include a soft tissue interposition. A novel technique using the whole of FCR as a soft tissue arthroplasty after trapezectomy is described.
Fifty-two trapezectomies with suspension arthroplasty using the whole of FCR were performed on 48 patients by one surgeon over a six year period.
Average follow-up was 1.8 years. Grip and pinch strengths were measured and compared with the contralateral hand and with pre-operative measurements. A Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was completed.
Of 48 patients, 42 responded to the follow-up request (87.5%) for a total of 43 operations. There were 32 females and 10 males with an average age of 54 years. There was no significant difference between the pre and post-operative pinch and grip strengths (pinch pre-op 5.4 kilogram, post-op 4.9 kilogram; grip pre-op 24 kilogram, post-op 21 kilogram). The average DASH sc ore was 41.8 (range 35–60.8), which is comparable to the other trapezectomy studies. When the patients were asked whether they would undergo the surgery again, 95% answered “yes”.
Our results using this novel technique demonstrated a DASH score comparable to other techniques using half of the FCR tendon, or no soft tissue interposition at all. Interestingly a significant fall in pinch strength (noted in other trapezectomy studies) was not a finding in this study.
Correspondence should be addressed to Associate Professor N. Susan Stott, Orthopaedic Department, Starship Children’s Hospital, Private Bag 92024, Auckland, New Zealand.
