Increased Complications in Trapeziectomy With Ligament Reconstruction and Tendon Interposition Compared With Trapeziectomy Alone

Abstract

Patients undergoing trapeziectomy with LRTI or Weilby had a greater incidence of reported complications when compared with trapeziectomy alone. These results suggest an advantage of simple trapeziectomy; however, further study is warranted.

Does occupational therapy delay or reduce the proportion of patients that receives thumb carpometacarpal joint surgery? A multicentre randomised controlled trial

“…A Cochrane review on CMCJ OA surgery evidence9 could not demonstrate whether any surgical technique for CMCJ OA conferred benefit over any other techniques, in terms of pain and physical function. However, more complicated surgery interventions were found to increase postoperative complications compared with a simple trapeziectomy 9–11…”

Basilar Thumb Arthritis: The Utility of Suture-Button Suspensionplasty

“…1,2 The publication of multiple comparative meta-analyses and systematic reviews demonstrating a lack of added clinical benefit in terms of pain or physical functioning following trapeziectomy with ligament reconstruction and tendon interposition procedures to trapeziectomy, combined with evidence of fewer complications following trapeziectomy alone, has led surgeons to critically evaluate their choice of procedure for the management of thumb basal joint arthritis. [3][4][5][6][7] In a search of an effective means to maintain trapezial space and stabilize the thumb metacarpal following trapeziectomy, suspensionplasty techniques anchoring the flexor carpi radialis (FCR) to the abductor pollicis longus (APL) tendons as a functional sling in the trapezial space have been described. Suspensionplasty techniques obviate the need to sacrifice a tendon for ligament reconstruction or use drill holes or pin fixation in the thumb metacarpal for stabilization.…”

Surgeon Preference, Influence, and Treatment of Thumb Carpometacarpal Arthritis

“…However, there has been growing evidence that LRTI is associated with greater complications, such as scar tenderness, sensory change, and regional pain syndromes compared with simpler techniques like trapeziectomy only. 9,[15][16][17] Two papers have previously examined trends in the treatment of CMC arthritis, both of which occurred more than 5 years ago. 4,18 In both papers, at least 60% of physicians who responded said they use trapeziectomy with LRTI as their primary treatment of choice.…”