Is single trapeziectomy sufficient in grade III and IV carpometacarpal (CMC) osteoarthritis?

Abstract

Objectives: The aim of this study was to compare the efficacy of simple trapeziectomy (ST) with trapeziectomy and flexor carpi radialis tendon interposition (T+LRTI) for grade III and IV CMC osteoarthritis in terms of clinical and radiological findings. Methods: Of the selected 13 patients, ST alone was applied to 7 (Group 1) and T+LRTI was applied to 6 (Group 2) by a single surgeon. Quick DASH and VAS scoring were used in the clinical evaluation; the grip, palmar pinch, key pinch and tip pinch were measured with a pinchmeter; the trapezial space ratio (TSR) was measured on the standard AP hand radiographs taken at the final follow-up. Clinical and radiological results of both groups were compared. Results: The mean follow-up period was 12 months in Group 1 and 17 months in Group 2. The postoperative final follow-up examination mean VAS values of Group 1 and 2 were 2 and 2.5, respectively; the Quick DASH scores were 23.2 and 27.4, respectively. Mean grip strength of Group 1 and 2 was measured as 13.2 and 12; palmar pinch strength as 3.9 and 4.6; key pinch strength as 5.6 and 4.3; and tip pinch strength as 8 and 5, respectively. The trapezial space ratio was measured with the final follow-up radiographs as mean 0.22 in Group 1 and 0.18 in Group 2. Conclusion: ST and T+LRTI have similar results and we believe that T+LRTI has no clinical or radiological benefits over ST in short-term follow-up.