Trapeziectomy for basal thumb joint osteoarthritis: 3- to 19-year follow-up

Abstract

A consecutive series of 40 trapeziectomies in 30 patients with basal thumb joint osteoarthritis was reviewed. Sixteen thumbs had pan-trapezial and 24 thumbs trapeziometacarpal osteoarthritis. Simple excision without soft tissue interposition was performed by the same surgeon using an identical surgical technique. Twentyeight patients were female (mean age 57 years) with a mean follow-up of 11 (3-19) years. Twenty-eight patients were satisfied with their operation, with 26 thumbs being pain free. Thumb pinch strength was improved by 40% compared to preoperative values, but still remained 22% weaker than the non-operated side.Résumé Une série de 40 trapézectomies pour arthrose trapézo-métacarpienne est présentée. Il s'agit de 30 patients dont 28 de sexe féminin, d'âge moyen 57 ans, avec un suivi de 11 ans (3 à 19). L'arthrose était péri-trapézienne dans 16 cas et trapézo-métacarpienne dans 24 cas. Une simple ablation du trapèze a été fait san interposition tissulaire, par la même Chirurgien. 28 patients sont satisfaits de l'intervention avec une première colonne indolore dans 26 cas. La force de la pince polycidigitale a été améliorée de 40% comparé à l'état pré-opératoire mais reste plus faible que celle du côté non opéré.

Estudo comparativo entre ressecção do trapézio e interposição tendinosa com e sem ligamentoplastia no tratamento da artrose carpometacarpiana do polegar

“…A simples ressecção do trapézio é relatada por poucos autores, como um possível risco de artrose entre as superfícies incongruentes da base do 1 o metacarpiano e do escafóide (32) . No entanto, estudos pós-operatórios de seguimentos a longo prazo não demonstraram essa complicação (3)(4)6) embora Iyer tenha observado quistos na base do 1 o metacarpiano em 60% de seus casos, que não influenciaram no resultado final (7) . Não observamos essas alterações nas nossas pacientes, mesmo nas operadas havia mais de 10 anos.…”

“…Ele ficou tão impressionado com o resultado, que realizou essa cirurgia em si mesmo, quando teve a rizartrose (apud Davis TR, et al) (2) . Posteriormente, outros autores relataram também bons resultados com essa cirurgia (3)(4)(5)(6)(7) . Devido à possível migração proximal e instabilidade, causadas pela ressecção do trapé-zio, que poderia, pelo menos teoricamente, ocasionar problemas à nova articulação, foram introduzidas outras técnicas com a finalidade de estabilizar a base do 1 o metacarpiano através de reconstruções ligamentares com ou sem interposição de material biológico ou não (8)(9)(10)(11)(12) .…”

Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: A study of the benefit of ligament reconstruction or tendon interposition

“…[11][12][13][14][15][16] Excision of the trapezium with the construction of a suspensory ligament is presently the most popular treatment option. Although there are many retrospective surveys reporting good results after excision of the trapezium with construction of a suspensory ligament 10,17,18 there are very few prospective studies on this treatment option 19 and only 2 studies that compare the outcome of this treatment with other surgeries in a randomized and prospective manner.…”

Degenerative Change at the Pseudarthrosis After Trapeziectomy at 6-year Followup

“…However, we are not aware of any studies that have assessed the pseudarthrois gap at longer followup after simple excision of the trapezium. Previous longer-term followup studies of this procedure have exclusively assessed the clinical outcome [13,14,21]. Our finding is particularly interesting because a Kirschner wire was not inserted during the simple trapeziectomy to hold the thumb metacarpal base away from the distal pole of the scaphoid during the immediate postoperative period.…”