FIRST CARPOMETACARPAL JOINT ARTHRITIS - A COMPARISON OF 2 ARTHROPLASTY TECHNIQUES

Trapeziectomy followed by reconstruction of the intermetacarpal ligame nt using a small slip of estensor carpi radialis longus tendon and a w ide slip of flexor carpi radialis for tendon interposition (group A) i s compared with trapeziectomy followed by palmaris longus tendon inter position (group B). Group A included 11 hands in nine patients. Group B included eight hands in eight patients. Significant pain at the base of the thumb and Ist carpometacarpal joint degeneration were indicati ons for surgery. Outcome was assessed by subjective questioning, objec tive clinical measurement and radiography Group A appeared to have a s lower recovery but later developed a stronger hand, better dynamic thu mb function despite reduced movement and the resting trapezial space w as better preserved. Calcification within the trapezial space correlat ed with better results but this took 3 years to occur. Patients in gro up B had greater relief of pain and were more consistently satisfied a t an early stage.