ABSTRACT
Introduction: Trapezio metacarpal joint arthritis is the commonest of arthritis in hand. It occurs more in females after age of 40 years (post menopausal women). Pain appears in all thumb movements which incapacitates them to do their daily household work. There are various methods of treating this disease like conservative methods including NSAIDS and hot water fomentation; surgical methods like trapeziectomy, stabilizing ligamentoplasty, prosthetic replacement (silicon implats, steffee prosthesis etc, fusion of trapezio metacarpal joint and tapeziectomy with tendon interposition arthroplasty. Non surgical measures forms the first line of treatment with aim of preventing progression of disease, however, surgery becomes an option when symptoms are refractory to nonsurgical methods. Aim: To evaluate the outcomes of trapeziectomy with free rolled tendon palmaris longus interposition arthroplasty for moderate to severe osteoarthritis of trapezio metacarpal joint. Material and methods: We evaluated 10 patients (mean age 50, Eaton Littler stage 3 and 4) who underwent trapeziectomy and palmaris longus interposition arthroplasy for end stage osteoarthritis of thumb carpometacarpal joint. Clinical outcome parameters were determined preoperatively and at 3, 6, and 12 months postoperatively. Results: We have got excellent in 7 cases (9 thumbs), good in 2 cases, poor in 1 case. Conclusion: Rolled tendon arthroplasty using free rolled palmaris longus tendon with trapeziectomy is able to provide high quality results in moderate to severe osteoarthritis of trapezio metacarpal joint.
ABSTRACT
PURPOSE: The purpose of this study was to evaluate surgical outcomes of thumb carpometacarpal osteoarthritis treated either by volar ligament reconstruction or trapeziectomy with suspensionplasty. MATERIALS AND METHODS: From July 2004 to January 2011, we treated 43 patients with thumb carpometacarpal joint arthritis by volar ligament reconstruction in stages I and II, and by trapeziectomy with suspensionplasty in stages III and IV. Out of the 43, we evaluated 19 patients (9 treated by volar ligament reconstruction, 10 treated by trapeziectomy with suspensionplasty) at an average of 36.8 months (range: 8 to 65 months) after surgery. Outcome measures included pain visual analogue scale (VAS), ranges of motion, and grip and pinch strengths. RESULTS: The mean VAS was 1.2 in the volar ligament reconstruction group and 2.0 in the trapeziectomy with suspensionplasty group at final follow-up. The ligament reconstruction group had significantly better thumb radial abduction and opposition ranges of motion, and key grip strength. No further radiographic arthritic changes were noted in the ligament reconstruction group at a mean follow-up of 39 months. CONCLUSION: The authors obtained satisfactory pain control in patients with thumb carpometacarpal osteoarthritis by volar ligament reconstruction for stages I-II and trapeziectomy with suspensionplasty for stages III-IV.