CMC arthritis: Resection Arthroplasty

- Discussion:
    - historically has yeilded good results in relieving pain;
    - disadvantages:
           - thumb shortening and subsidence, weakness of pinch, and decreased ability to adduct the thumb;

- Operative Technique:
    - dorsal longitudinal incision centered over CMC joint;
          - incision is curved volarly at the base of thenar eminence;
    - superficial branches of the radial nerve are identified;
    - abductor pollicis longus is transected 1.5 cm proximal to its insertion;
    - EPB is retracted dorsally;
    - longitudinal incision is made in CMC capsule, exposing the trapezium;
    - reflect thenar muscles distally off their insertion onto scaphoid and trapezium;
    - divide oblique ligaments (anterior and posterior) on ulnar side of metacarpal;
    - remove the trapezium;
    - interposition may consist of rolled up palmaris longus or gel foam;
    - abductor pollicis longus is shortened 1 cm and repaired

Treatment of trapeziometacarpal arthritis: Results of resection arthroplasty.

Stabilized resection arthroplasty by an anterior approach in trapeziometacarpal arthritis: results and surgical technique.

The results of excision of the trapezium.  

Excision of the trapezium in osteoarthritis of the first carpometcarpal joint.  

Trapezial space height measurement after trapeziectomy: A comparison of the use of standard and stress radiographs

Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint: a study of the benefit of ligament reconstruction or tendon interposition.

Five- to 18-Year Follow-Up for Treatment of Trapezoimetacarpal Osteoarthritis: A Prospective Comparison of Excision, Tendon Interposition, and Ligament Reconstruction and Tendon Interposition.

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, March 15, 2012 11:58 am