Jn. Rutegard et al., TENDON ARTHROPLASTY FOR TREATMENT OF TRAPEZIOMETACARPAL ARTHROSIS, Scandinavian journal of plastic and reconstructive surgery and hand surgery, 28(4), 1994, pp. 295-298
Trapeziometacarpal arthrosis is common among middle-aged women, and th
e surgical treatment options include arthrodesis, excision of the trap
ezium, prosthetic replacement of the trapezium, reconstruction of the
ligaments, and various tendoplasties. We have prospectively studied a
simple tendoplasty in which a strip of abductor pollicis longus tendon
was anchored to the flexor carpi radialis tendon, the intact part of
the abductor pollicis tendon, and the joint capsule, after excision of
the trapezium, and carried out 27 operations in 25 patients. The thum
b was immobilised for only eight days. Systematic exercises were start
ed on the day of operation. Complete pain relief was obtained in 17 pa
tients and partial relief in eight. Grip strength improved. The mobili
ty was unaltered and functionally satisfactory. Three patients were re
operated on for cutaneous nerve entrapment and one for carpal tunnel s
yndrome. The procedure is simple, and the patients' symptoms improved
without failures. The intensive supervised postoperative physiotherapy
was essential to achieve the final results.