Ligament Reconstruction and Tendon Interposition Using Flexor Carpi Radialis Tendon for the Treatment of Basilar Thumb Arthritis: A Case Report

Introduction: Basilar thumb arthritis is most common arthritis affected about 10% of middle aged women and one third of postmenopausal women had this condition. The disease is often not shown significant symptom, when become a symptomatic can provide 50% loss of function. Conservative treatment with mild arthtritis usually had a good respond. Surgery is indicated in patients who failed to conservative treatment. Ligament reconstruction and tendon interposition is the surgical approach commonly used to treat basal joint arthtritis. Case Presentation: A 61-year-old woman complained swelling and also pain at the base of the left thumb more than 1 year and unable to do a daily activity and getting worse, also complained weakness grip. Plain radiograph of hand showed the trapezial space height about 10mm and diagnosed with basilar thumb arthritis of the left hand Eaton stage III with DASH score pre operatively is 60.8. The patient done with LRTI procedure and used thumb spica cast for immobilized 4 weeks. The DASH Score Post operatively is 40.7 and after 6 months the score is improve to 19.2. Conclusion: Basal Thumb Arthritis is a common condition affecting postmenopausal women with a deformity consisting of a MCP hyperextension deformity accompanied by swelling, tenderness and crepitus. Eaton Classification used to staging of basal thumb arthritis and help to decide the treatment. LRTI is one approach to treat patients with CMC arthritis who has a high level of satisfaction and objectivity in measuring function, including restoring of the strength and ability of the affected thumb. Keywords: Basilar, Thumb, Joint, Arthritis, Ligament reconstruction, tendon interposition.