Suspension arthroplasty of the thumb carpometacarpal joint

Purpose. A modified surgical technique using suspension arthroplasty against primary osteoarthritis of the thumb carpometacarpal joint was analysed. Material and Methods. This retrospective analysis focused on 41 patients who underwent suspension arthroplasties with a modified technique between 1997-2005. With the help of this technique, a long-range preparation of the flexor carpi radialis tendon can be avoided. Only the ca. 3 cm of tendon which is visible in the site was split in half and cut off proximally. This half tendon was provided with a suture in baseball-stitch technique. It was then press-fit fixed with a suture in a sloping drill hole of the MC 1 basis. The patients required a cast for only 3 weeks postoperatively. Afterwards, they received an orthesis for 2-3 weeks with increasing mobilisation. The postoperative course was clinically and radiologically analysed. The results were analysed at 3 months and 1-7 years after surgery. All patients were operated as outpatients. Results. Of the 41 patients, 40 had a high subjective satisfaction. A total of 45 operations showed excellent results. There were no poor results. Only one patient would not undergo the surgery again. The radiological distance between metacarpal 1 and the distal scaphoid lay between 4 mm and 9 mm after 3 months and 1-7 years. Conclusion. The described modification of suspension arthroplasty with a short-range mobilisation of the flexor carpi radialis tendon reduced the morbidity of preparation and led to stable suspension. Thus, immobilisation over 3 weeks was not necessary. Patients obtained good, early functional results.