Surgical management of trapezio-metacarpal joint arthritis. Comparison of two techniques

ABSTRACT

Osteoarthritis at the base of the thumb affecting the trapeziometacarpal [TMC] joint is a common, painful and disabling condition that severely compromises function of the entire hand. Successful treatment is based on an understanding of the specific anatomy and the unique functional attributes of the human hand and thumb. Surgical procedures for this problem include extra articular ligamentous reconstruction, partial or complete resection of the trapezium with or without tendon interposition arthroplasty, arthrodesis of the trapeziometacarpal joint, osteotomy of the thumb metacarpal, silicone interposition arthroplasty and total joint arthroplasty. The results of this prospective study were represented in which qualitative and quantitative outcomes were assessed clinically and radiographically in 47 thumbs in 40 patients with thumb basal joint arthritis affecting the trapeziometacarpal joint treated with beak ligament reconstruction with tendon interposition arthroplasty [LRTI] [group I including 25 thumbs] or with arthrodesis of the TMC joint [group II including thumbs]