Save the trapezium: double interposition arthroplasty for the treatment of stage IV disease of the basal joint

The Journal of Hand Surgery
O A Barron, R G Eaton

Abstract

Twenty patients with symptomatic stage IV basal joint (pantrapezial) arthritis were treated with double interposition arthroplasty, a new technique that resurfaces the degenerative trapeziometacarpal and scaphotrapezial joints after minimal distal trapezial resection. The results of the 21 procedures were reviewed clinically and radiographically after a mean follow-up period of 34 months (minimum, 1 year). Ninety-one percent of the patients were completely satisfied. Seventy-one percent were entirely free of pain, and an additional 24% noted only occasional, mild, high-stress pain that did not limit their activities. One case was a clinical failure. Objectively, all 21 basal joints were stable, with active range of motion to within 90% of normal. Mean grip strength increased 32%, from a force of 26.1 kg to 33.9 kg (p < .01). Key pinch strength increased from a force of 5.3 kg to 6.0 kg (an 11% increase; p = .05). A new method of determining changes in basal joint height indicated a mean decrease in height of 5.3% (range, 0%-12%) at rest and 8.1% (range, 0%-20%) under axial compression. This difference was statistically but not functionally significant. Overall, there were 95% good or excellent results and 1 poor result. We beli...Continue Reading

Associated Clinical Trials

Jun 20, 2011·Melvin Rosenwasser

References

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