Trapeziectomy made simpler (and quicker)

Abstract

BACKGROUND Trapeziectomy for thumb carpal-metacarpal joint arthritis yields good results in terms of improvement of pain and physical function.1 Traditional piecemeal trapeziectomy can be time-consuming. We describe a quick and simple way to remove the trapezium in one piece. TECHNIQUE A standard approach to the trapezium is made with protection of the radial nerve, the trapezium being exposed with a longitudinal incision in the carpometacarpal ligament.2 A 2.5mm drill is used to drill across the bulk of the trapezium (Fig. 1). A cortical 3.5mm tap is then inserted and used for leverage and retraction (Fig. 2) while soft tissue is dissected from around the bone using a scalpel, allowing delivery of the complete trapezium attached to the tap (Fig. 3). DISCUSSION We have found this method for excision of the trapezium to be slick and effective and to have good results. We have seen a time saving of around 15 minutes per procedure. We cannot claim credit for this technique, it being shown to us by one of the authors who learnt it in the US.