Thumb metacarpophalangeal capsulodesis: An adjunct procedure to basal joint arthroplasty for collapse deformity of the first ray

Trapézectomies et ligamentoplasties de suspension au Gore-Tex® : résultats préliminaires sur 43 arthroses trapézométacarpiennes

“…Cette hyperextension a été retrouvée comme le facteur péjorant significativement le résultat de la préhension dans notre série. Pour cette raison et au vu de la littérature [7,10,30], nous réalisons maintenant une capsulodèse antérieure de la MCP, en cas d'hyperextension de la MCP supérieur ou égale à 308 en préopératoire.…”

Volar Capsulodesis of the Thumb Metacarpophalangeal Joint at the Time of Basal Joint Arthroplasty: A Surgical Technique Using Suture Anchors

“…All candidates for basal joint arthroplasty had radiographic evidence of stage 3 or greater arthritis as described by Eaton and Floyd. 10 Exclusion criteria included patients with rheumatoid arthritis, cerebral palsy, or thumb MCP arthritis. We excluded patients who had previous or concomitant hand procedures such as carpal tunnel, trigger thumb, or de Quervain release, to limit confounding variables that could potentially affect patients' pre-operative or postoperative clinical evaluation.…”

Metacarpophalangeal Joint Hyperextension and the Treatment of Thumb Basilar Joint Arthritis

“…Given inefficient interphalangeal flexion, the force required for pinch is transmitted to the metacarpal head instead of the tip of the distal phalanx. 12 Moineau and colleagues 13 studied the prognostic factors associated with a successful outcome after trapeziectomy and ligament stabilization. Of the variables identified, they noted that 36 of 51 patients had untreated hyperextension of the MCP joint (average 26°) and that this contributed to a loss of trapezial height, weakness, and subsequent worse hand function postoperatively.…”

“…Pinch strength was increased by 50%, with 10 patients having complete resolution of MCP hyperextension. Numerous other surgical procedures have been described to manage MCP deformity based on varying degrees of hyperextension, including extensor pollicis brevis transfer, 14,15 volar plate advancement or imbrication, 12,16,17 abductor pollicis brevis to the A1 pulley, 18 and arthrodesis. 14 Poulter and Davis 19 recently examined the outcome of patients who underwent surgical treatment of trapeziometacarpal joint arthritis with varying degrees of MCP joint hyperextension.…”

“…12,15,16,18,20 Treatment algorithms have been published to guide the management of MCP hyperextension, and include cast application or no treatment for extension less than 10°, percutaneous pinning of the MCP joint or extensor pollicis brevis transfer for deformities between 10°and 20°, volar capsulodesis or sesamoidesis for deformities between 20°and 40°, and arthrodesis for deformities greater than 40°. 2,10 Despite the heterogeneity in treatment methods, the variability in functional outcome measures reported and the lack of specificity of these outcomes for thumb function make direct comparison even more difficult.…”