Purpose
Trapeziectomy has frequently been used to treat basal thumb osteoarthritis. However,
complications, such as shortening of the thumb ray and reduced mobility and strength,
can occur. The aim of this study was to present a 10-year follow-up of distraction
arthroplasty without trapeziectomy.
Methods
Fifteen patients were followed for a mean of 121 months (range, 121–124 months). Subjective
outcomes were evaluated with the Disabilities of the Arm, Shoulder, and Hand questionnaire,
while the pain intensity was assessed with a Visual Analog Scale both before surgery
and at the end of follow-up. Objective outcomes were obtained using the Kapandji score
and an assessment of grip and pinch strength. Preoperative and final postoperative
x-rays were obtained to evaluate metacarpal subsidence and progression of trapezial-metacarpal
joint arthritis.
Results
The Visual Analog Scale score was reduced from 9.4 ± 0.5 before surgery to 2.5 ± 1
at follow-up. The mean Disabilities of the Arm, Shoulder, and Hand questionnaire score
was 75.6 ± 12.6 before surgery and 16.9 ± 4 at 10 years. Hand grip strength of the
operated side (26 ± 5.5 kg) achieved 95% of functionality compared to the opposite
side, while key pinch strength (6.4 ± 1.6 kg) reached 93%. A Kapandji opposition score
of 10 points was found in 12 patients, a score of 9 was found in 1, and a score of
8 was found in 2.
Conclusions
Distraction arthroplasty of the trapeziometacarpal joint ensures good results in long-term
follow-up, when performed in patients with stage I–II basal thumb osteoarthritis.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: June 16, 2022
Accepted:
April 27,
2022
Received:
September 13,
2021
Publication stage
In Press Corrected ProofFootnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
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© 2022 by the American Society for Surgery of the Hand. All rights reserved.
