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Biomechanical Analysis of Abductor Pollicis Longus Lasso Suspensionplasty for Trapeziectomy
Brahman Sivakumar1, David Graham2, Owen Ou Yang3
1Department of Hand & Peripheral Nerve Surgery, Royal North Shore Hospital, St Leonards, Australia; Department of Orthopaedic Surgery, Gold Coast University Hospital, Southport, Australia.
Purpose:
Multiple methods of ligament reconstruction and tendon interposition (LRTI) or suspension have been described to prevent first metacarpal subsidence following trapeziectomy. An abductor pollicis longus (APL) lasso is a newly described technique of suspensionplasty, which aims to obviate concerns regarding previously described methods. The purpose of this study was to compare subsidence between the APL lasso and 2 other common methods, APL sling and flexor carpi radialis LRTI, after trapeziectomy in cadaveric forearms.
Methods:
Ten cadaveric forearms were prepared on a custom-made plinth to recreate pinch grip upon the loading of previously identified muscles. A sequence of procedures was performed, with radiographs taken after each to assess the subsidence.
Results:
The APL lasso was superior to simple trapeziectomy and flexor carpi radialis LRTI in preventing subsidence.
Conclusions:
The APL lasso was superior to simple trapeziectomy and flexor carpi radialis LRTI in preventing subsidence, and it may be a viable alternative when considering suspension methods after trapeziectomy.
Clinical Relevance:
The APL lasso may be considered when trying to prevent subsidence after trapeziectomy.
