J Brand1, R Gaulke, J Geerling, R Meller, C Krettek. 1. Chirurgische Gemeinschaftspraxis Brand, Dyck, Schulz, Cellerstr 24, 29525, Uelzen, Germany. brand@branddyckschulz.de
Abstract
PURPOSE: A modified surgical technique using suspension arthroplasty against primary osteoarthritis of the thumb carpometacarpal joint was analysed. MATERIAL AND METHODS: This retrospective analysis focused on 41 patients who underwent suspension arthroplasties with a modified technique between 1997-2005. With the help of this technique, a long-range preparation of the flexor carpi radialis tendon can be avoided. Only the ca. 3 cm of tendon which is visible in the site was split in half and cut off proximally. This half tendon was provided with a suture in baseball-stitch technique. It was then press-fit fixed with a suture in a sloping drill hole of the MC 1 basis. The patients required a cast for only 3 weeks postoperatively. Afterwards, they received an orthesis for 2-3 weeks with increasing mobilisation. The postoperative course was clinically and radiologically analysed. The results were analysed at 3 months and 1-7 years after surgery. All patients were operated as outpatients. RESULTS: Of the 41 patients, 40 had a high subjective satisfaction. A total of 45 operations showed excellent results. There were no poor results. Only one patient would not undergo the surgery again. The radiological distance between metacarpal 1 and the distal scaphoid lay between 4 mm and 9 mm after 3 months and 1-7 years. CONCLUSION: The described modification of suspension arthroplasty with a short-range mobilisation of the flexor carpi radialis tendon reduced the morbidity of preparation and led to stable suspension. Thus, immobilisation over 3 weeks was not necessary. Patients obtained good, early functional results.
PURPOSE: A modified surgical technique using suspension arthroplasty against primary osteoarthritis of the thumb carpometacarpal joint was analysed. MATERIAL AND METHODS: This retrospective analysis focused on 41 patients who underwent suspension arthroplasties with a modified technique between 1997-2005. With the help of this technique, a long-range preparation of the flexor carpi radialis tendon can be avoided. Only the ca. 3 cm of tendon which is visible in the site was split in half and cut off proximally. This half tendon was provided with a suture in baseball-stitch technique. It was then press-fit fixed with a suture in a sloping drill hole of the MC 1 basis. The patients required a cast for only 3 weeks postoperatively. Afterwards, they received an orthesis for 2-3 weeks with increasing mobilisation. The postoperative course was clinically and radiologically analysed. The results were analysed at 3 months and 1-7 years after surgery. All patients were operated as outpatients. RESULTS: Of the 41 patients, 40 had a high subjective satisfaction. A total of 45 operations showed excellent results. There were no poor results. Only one patient would not undergo the surgery again. The radiological distance between metacarpal 1 and the distal scaphoid lay between 4 mm and 9 mm after 3 months and 1-7 years. CONCLUSION: The described modification of suspension arthroplasty with a short-range mobilisation of the flexor carpi radialis tendon reduced the morbidity of preparation and led to stable suspension. Thus, immobilisation over 3 weeks was not necessary. Patients obtained good, early functional results.