Tendon arthroplasty for treatment of trapeziometacarpal arthrosis

Trapeziometacarpal arthrosis is common among middle-aged women, and the surgical treatment options include arthrodesis, excision of the trapezium, prosthetic replacement of the trapezium, reconstruction of the ligaments, and various tendoplasties. We have prospectively studied a simple tendoplasty in which a strip of abductor pollicis longus tendon was anchored to the flexor carpi radialis tendon, the intact part of the abductor pollicis tendon, and the joint capsule, after excision of the trapezium, and carried out 27 operations in 25 patients. The thumb was immobilised for only eight days. Systematic exercises were started on the day of operation. Complete pain relief was obtained in 17 patients and partial relief in eight. Grip strength improved. The mobility was unaltered and functionally satisfactory. Three patients were reoperated on for cutaneous nerve entrapment and one for carpal tunnel syndrome. The procedure is simple, and the patients' symptoms improved without failures. The intensive supervised postoperative physiotherapy was essential to achieve the final results.