CLINICAL AND RADIOLOGICAL RESULTS AFTER TRAPEZIECTOMY WITH EXTENSOR CARPI RADIALIS LONGUS SUSPENSION: A FIVE TO TEN YEARS FOLLOW UP

Abstract

Objectives: Evaluation of patients satisfaction, radiological and functional outcome in patients with trapeziometacarpal osteoarthritis after trapeziectomy with a extensor carpi radialis longus suspension.

Material and Methods: Between November 1997 and Dezember 2003, 44 patients (34 female, 10 male, average age 60 years, range 46 to 73 years) underwent trapeziectomy with extensor carpi radialis longus suspension at our institution. In 37 patients clinical and radiological outcome could be assessed after an average follow up of 7 years (range 5 to 10 years). 7 patients were lost to follow up. Preoperative range of motion, pain intensity (VAS) function and radiographs were evaluated. Postoperative patients satisfaction, using the DASH score functional and radiological outcome was determined.

Results: The average patients satisfaction was 27.8 points (range 0 – 70). Pain intensity improved from pre-operative VAS 8.5 (range 6.3 – 10) to postoperative 1.9 (range 1.2 to 4). 92 % of patients would again choose this surgical procedure. Duration of pain anamnesis was 24 months or longer in 64% of patients. After 3 months full pain relief and usage property was achieved in 62% of patients.

A free opposition was possible in 76%, radial abduction of 40° was possible in 24%, of 30–40° in 38% and of 20–30° in 35% of patients. Palmar abduction of more than 40° was possible in 68% and 30 – 40° in 32% of patients. Grip strength deteriorated in 49%, in 16% there was no difference and improved in 35% compared to the other hand. The average trapezium space lost 18% of its height compared with preoperative values.

Conclusion: Trapeziectomy with extensor carpe radialis longus suspension shows good results regarding pain relief but remarkable deterioration of strength.