Thumb Carpometacarpal Suspension Arthroplasty With Flexor Carpi Radialis Ligament Reconstruction and Tendon Interposition Using An Absorbable Interference Screw

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kevin D. Plancher ◽  
Sarah V. Stelma ◽  
Linda M. Wong ◽  
Stephanie C. Petterson
1985 ◽  
Vol 10 (1) ◽  
pp. 115-116 ◽  
Author(s):  
A. MAGNUSSON ◽  
K. BERTHEUSSEN ◽  
A. WEILBY

A modification of the Eaton and Littler technique for reconstructing ligaments and restoring stability of the carpometacarpal joint of the thumb is described. We use a strip from the flexor carpi radialis tendon, which is split down to the crest of the trapezium. The tendon strip is led beneath the ligaments and the abductor pollicis longus insertion, through a tunnel drilled in the metacarpal base, around the insertion of the flexor carpi radialis tendon and finally back to the dorsum of the base of the metacarpal where it is inserted in the periosteum. This procedure ensures a dynamic fixation of the apical ligament and therefore a better stability.


Author(s):  
Eknoor Kaur ◽  
Narender Saini ◽  
Shashank Sharma ◽  
Devi Sahai Meena

<p><strong>Background</strong>: The purpose of this study is to assess the functional outcome of the cases with advanced thumb carpometacarpal (CMC) arthritis treated with trapeziectomy and ligament reconstruction tendon interposition (LRTI) in terms of visual analogue scale (VAS), disabilities of the arm, shoulder and hand (DASH) score, Kapandji score, range of motion (ROM) of radial and volar abduction of the thumb, grip power, key pinch and the height of the trapezial space.</p><p><strong>Methods</strong>: In a prospective before and after interventional study of 30 patients with the advanced thumb CMC joint arthritis underwent the procedure. An average follows up period was 17.9 months.</p><p><strong>Results:</strong> The mean VAS decreased from 8.17 to 2.70. The mean Kapandji score and DASH score improved from 3.47 and 71.62 preoperative to 8.23 and 14.46 postoperative.  Mean ROM for radial and volar abduction increased from 42.57° and 48° to 61°and 64.73° respectively. Mean key pinch power and grip power increased from 2.80 kg and 3.47 kg to 4.70 kg and 9.01 kg respectively.  There was a significant decrease in height of the trapezial space. Three patient complaint of the persistent pain at the surgical site and not much improvement in the DASH score.</p><p><strong>Conclusions:</strong>  Trapeziectomy with LRTI using flexor carpi radialis (FCR) transfer is an effective treatment for the advanced thumb CMC arthritis. This procedure stabilizes thumb metacarpal and provide enough support which prevents the collapse of metacarpal into dead space.</p>


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