Ligament reconstruction and tendon interposition arthroplasty of the trapeziometacarpal joint with the use of the full thickness of the flexor carpi radialis tendon

We analyzed the outcomes of the ligament reconstruction and tendon interposition arthroplasty of the trapeziometacarpal joint with use of the full thickness of the flexor carpi radialis. We reviewed 19 patients, with 23 thumbs at mean follow-up of 59 +/- 15 months. According to Dell classification, 11 thumbs were grade 2, and 12 thumbs were grade 3. The preoperative VAS pain score was 7 +/- 0.9 and thumb web space was 23 +/- 2.4 degrees. The preoperative grip strength was 13 +/- 0.7 kg, tip pinch strength was 2.8 +/- 0.5 kg and lateral pinch strength was 4 +/- 0.9 kg. None of the thumbs could touch the palmar crease of the little finger. The final outcome was 0.9 +/- 1.4 for VAS, 19 +/- 1 kg for grip strength, 4.5 +/- 0.3 kg for tip pinch strength, 5.6 +/- 0.5 kg for lateral pinch strength and 38 +/- 2.4 degrees for thumb web space. Mobility of the thumbs was improved; 19 thumbs could touch the base of the fifth finger, and five thumbs could touch the crease of the proximal interphalangeal joint. We compared the operated side with the healthy one in 15 patients, the grip strengths were 82% of the contralateral side, tip pinch strengths 78%, and lateral pinch strengths as 75%. According to our series, this surgical technique relieves pain and provides stability and mobility of the thumb. (C) 2012 Elsevier Masson SAS. All rights reserved.