Scaphotrapezoid arthritis: Prevalence in thumbs undergoing trapezium excision arthroplasty and efficacy of proximal trapezoid excision

Between June 1995 and May 1998, 37 patients underwent trapezium excision ar throplasty. Preoperative radiographic assessment for scaphotrapezoid arthri tis was performed. At the time of surgery intraoperative inspection of the scaphotrapezoid joint allowed calculation of the true prevalence of arthrit is as well as sensitivity and specificity of the radiographic diagnosis. Th e true prevalence of scaphotrapezoid arthritis was 62%. The sensitivity of the radiographic diagnosis was 44% and the specificity was 86%. Comparison of surgical results in 23 patients who underwent both trapezium excision ar throplasty and proximal trapezoid excision, with 14 patients who underwent the former procedure, only showed that there was no morbidity associated wi th the latter. Because of the potential that scaphotrapezoid arthritis may cause residual symptoms following trapezium excision arthroplasty, and in l ight of the low sensitivity of radiographs, routine intraoperative assessme nt of the joint is recommended so that proximal trapezoid excision can be p erformed ii degenerative change is present (J Hand Surg 1999;24A:1220-1224. Copyright (C) 1999 by the American Society for Surgery of the Hand.)