Trapeziectomy

Primary osteoarthritis of the carpometacarpal joint of the thumb is common, especially in women aged 60 or older. Patients usually present with activity-related pain at the thumb base. First treatment may include activity modification, pain relieving medications, splinting, and possibly corticosteroid injections. When these measures fail to pre-serve or restore the patient's quality of life, surgical intervention may be appropriate. Many surgical alternatives are described for the treatment of thumb carpometacarpal joint arthritis, and most begin with at least partial trapeziectomy. Hematoma-distraction arthroplasty results in improved outcomes as compared with historical results following trapeziectomy alone. Temporary distraction allows the body's healing response to fill in the trapezial void with scar tissue, obviating the need for ligament reconstruction or tissue interposition.