A comparison of trapeziectomy via anterior and posterior approaches

Forty-three hands in 41 adults with osteoarthrosis of the trapeziometacarpal joint were allocated randomly to undergo a trapeziectomy through either an anterior approach or the posterior (dorsoradial) approach. Forty hands were available for review at a median of 33 months postoperatively. The demographic characteristics, severity of disease and pre-operative measurements of the two groups were indistinguishable. Trapeziectomy resulted in significantly improved objective and subjective function in both groups, but the anterior approach group had better outcomes for power, scar tenderness and satisfaction. Scar-related complications were three times more common in the posterior group. Trapeziectomy is a good method of treating osteoarthritis of the thumb base, but outcomes for the anterior approach are equally good or better than with the posterior.