- 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.
PC Dell MD, TM Brushart MD, and RJ Smith MD. Journal of Hand Surgery. Vol 3, No 3, pages 243-249.
Stabilized resection arthroplasty by an anterior approach in trapeziometacarpal arthritis: results and surgical technique.
The results of excision of the trapezium.
KM Iyer.
Hand Vol 13. 1981. p 246.
Excision of the trapezium in osteoarthritis of the first carpometcarpal joint.
A. Murley.
JBJS 42-B. 1960. p 502.
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.
