Scaphometacarpal Space and Postoperative Outcomes: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Biomechanics

Background:

• Trapeziometacarpal (TMC) arthritis is commonly treated with procedures like trapeziectomy or ligament reconstruction and tendon interposition (LRTI).
• A prevailing belief is that LRTI preserves scaphometacarpal (SMC) space better than trapeziectomy, leading to improved functional results.
• This systematic review examines the link between SMC space and surgical outcomes in TMC arthritis.

Purpose of the Study:

• To systematically review the literature on TMC arthritis surgery.
• To evaluate the association between postoperative scaphometacarpal (SMC) space and objective (grip/pinch strength) and subjective patient-reported outcomes.
• To determine if preserving SMC space correlates with better functional recovery.

Main Methods:

• A systematic literature review was conducted following PRISMA guidelines.
• Included studies reported SMC space measurements and surgical outcomes after TMC arthritis treatment.
• Primary outcomes assessed were postoperative SMC space (e.g., trapezial height) and grip/pinch strength.

Main Results:

• Fourteen studies met the inclusion criteria for this review.
• Only three studies (21.4%) found a statistically significant correlation between SMC space and strength outcomes.
• Observed correlations between SMC space and strength were weak and inconsistent (positive and negative).

Conclusions:

• Postoperative scaphometacarpal (SMC) space preservation is not demonstrably linked to improved functional outcomes in TMC arthritis surgery.
• Current evidence does not support the notion that preserving SMC space leads to superior grip or pinch strength.
• Further investigation is required to clarify the role of SMC space maintenance in patients undergoing LRTI for TMC arthritis.