Pat B Roman1, Joshua D Linnell2, John B Moore2. 1. Department of Plastic and Reconstructive Surgery, University of Kansas Medical Center, Kansas City, KS. Electronic address: proman@kumc.edu. 2. Department of Plastic and Reconstructive Surgery, University of Kansas Medical Center, Kansas City, KS.
Abstract
PURPOSE: To describe the technique and a single-surgeon experience with a suture suspension and first dorsal compartment release treatment for thumb trapeziometacarpal (TMC) osteoarthritis. METHODS: We performed 19 procedures on 18 patients using this technique and compared results with preoperative assessment. At an average of 20 months (range, 8-45 months) after surgery, standard measures after TMC joint arthroplasty were performed. RESULTS: All patients had advanced Eaton stage III or IV osteoarthritis. Grip strength, key pinch, and thumb abduction showed statistically significant increases of 7 kg, 0.7 kg, and 4°, respectively. Seventeen of 18 patients no longer had reports of TMC joint pain on follow-up. There was one reoperation for pain because of osteophytes at the ulnar surface of the thumb metacarpal base, which resolved with proximal metacarpal excision. One case of index metacarpal fracture was treated with an orthosis. CONCLUSIONS: This surgical technique for the treatment of thumb TMC joint arthritis achieved pain relief and recreated support of the base of the metacarpal to resist proximal migration or radial deviation. This technique also provided an increase in grip strength and key pinch with return of range of motion early in the postoperative period. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
PURPOSE: To describe the technique and a single-surgeon experience with a suture suspension and first dorsal compartment release treatment for thumb trapeziometacarpal (TMC) osteoarthritis. METHODS: We performed 19 procedures on 18 patients using this technique and compared results with preoperative assessment. At an average of 20 months (range, 8-45 months) after surgery, standard measures after TMCjoint arthroplasty were performed. RESULTS: All patients had advanced Eaton stage III or IV osteoarthritis. Grip strength, key pinch, and thumb abduction showed statistically significant increases of 7 kg, 0.7 kg, and 4°, respectively. Seventeen of 18 patients no longer had reports of TMC joint pain on follow-up. There was one reoperation for pain because of osteophytes at the ulnar surface of the thumb metacarpal base, which resolved with proximal metacarpal excision. One case of index metacarpal fracture was treated with an orthosis. CONCLUSIONS: This surgical technique for the treatment of thumb TMC joint arthritis achieved pain relief and recreated support of the base of the metacarpal to resist proximal migration or radial deviation. This technique also provided an increase in grip strength and key pinch with return of range of motion early in the postoperative period. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.