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Stabilization of the pre-arthritic trapeziometacarpal joint using ligament reconstruction
N Van Giffen1, H Van Ransbeeck, L De Smet
1Department of Orthopaedic Surgery, U.Z. Pellenberg, Weligerveld 1, 3212 Lubbeek, Pellenberg, Belgium.
Introduction:
Trapeziometacarpal pre-arthrosis is a common condition with only limited therapeutic possibilities. Eaton and Littler designed a tendon stabilization.
Materials And Methods:
A series of 21 thumbs with painful carpometacarpal joints, treated with a ligament reconstruction according to Eaton and Littler, is described. Three failed and further surgery was required. The outcome of 18 is evaluated. There were 11 women, 7 men with a mean age of 33.7 years, all having stages I or II of osteoarthritis. Six (30%) had a traumatic event in their history.
Results:
In the early stages of degenerative osteoarthritis, the overall outcome was good with a mean DASH score of 23.2. The carpometacarpal joint was stable but a 43% progression of radiographic osteoarthritic deterioration of the joint occurred.
Conclusion:
Stabilization of a painful pre-arthritic trapeziometacarpal joint is useful and reliable. A traumatic instability had worse results and probably is a contraindication to this technique.