Abstract
The current benchmark for the treatment of Eaton stage I disease of the trapeziometacarpal
(TMC) joint includes palmar oblique ligament reconstruction and reflects its primary
role in providing stability during lateral pinch. This study prospectively evaluates
the efficacy of an alternative extra-articular approach using a 30° extension osteotomy
of the thumb metacarpal to redistribute trapeziometacarpal contact area and load,
obviating the need for ligament reconstruction. Preoperative and postoperative subjective
and objective data are reported for 12 patients enrolled in the study between 1995
and 1998. Trapeziometacarpal arthrotomy allowed accurate intra-articular assessment
and verified palmar oblique ligament incompetence in each case. The average follow-up
period was 2.1 years (range, 6-46 months). All osteotomies healed at an average of
7 weeks. Eleven patients were satisfied with outcome. Grip and pinch strength increased
an average of 8.5 and 3.0 kg, respectively. Thumb metacarpal extension osteotomy is
an effective biomechanical alternative to ligament reconstruction in the treatment
of Eaton stage I disease of the trapeziometacarpal joint. (J Hand Surg 2000;25A:1100-1106.
Copyright © 2000 by the American Society for Surgery of the Hand.)
Keywords
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Article info
Publication history
Accepted:
June 20,
2000
Received:
February 1,
2000
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject fo this article.
**Reprint requests: Matthew M. Tomaino, MD, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Ave, Suite 1010, Pittsburgh, PA 15213.
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
