A three-step technique to correctly identify the trapezium without the need for fluoroscopic imaging

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rheumatology

Background:

• Degenerative arthritis of the thumb's carpometacarpal joint causes significant pain and disability.
• Basal joint arthroplasty, often involving trapeziectomy, is a primary treatment for thumb arthritis.
• Incorrect bone excision during trapeziectomy has been documented, highlighting the need for accurate bone identification.

Purpose of the Study:

• To describe a reliable three-step technique for confirming trapezium identity before excision in basal joint arthroplasty.
• To present a method that minimizes the risk of excising the wrong bone during trapeziectomy for thumb arthritis.

Main Methods:

• A routinely used three-step surgical technique to identify the trapezium.
• Application of the technique in over 300 cases of basal joint arthroplasty.

Main Results:

• The described technique reliably confirmed trapezium identity prior to excision.
• Successful trapezium excision was achieved in all cases without the need for intraoperative fluoroscopy.
• No instances of incorrect bone excision were reported using this method.

Conclusions:

• The three-step technique provides a reliable and safe method for trapezium identification during basal joint arthroplasty.
• This approach enhances surgical accuracy and patient safety in treating thumb carpometacarpal joint arthritis.
• The technique eliminates the need for intraoperative fluoroscopy, potentially reducing costs and radiation exposure.