Treatment of degenerative arthritis of the first carpometacarpal joint with trapezium excision and flexor carpi radialis suspension

Abstract

Objective To evaluate the treatment outcomes of trapezium excision combined with flexor carpi radialis suspension for degenerative arthritis of the first carpometacarpal(CMC)joint.Methods Eight cases of degenerative arthritis of the first CMC joint were treated with trapezium excision combined with flexor carpi radialis suspeasion.Recovery of wrist function was evaluated using Krimmer wrist score.Improvement of quality of life after the operation was evaluated according to DASH questionnaires.Results The patients were followed up for 8 to 26 months postoperatively,with an average period of 15 months.The examinations included pain intensity,range of motion of the CMC joint,grip strength and X-ray images before and after the operation.The pain score of the first CMC joint was(5.6±2.2)preoperatively vs(1.6±1.0)postoperatively.Thumb adduction and abduction was(32.0±10.0)° preoperatively vs(58.0±13.0)° postoperatively,while thumb flexion and extension wss(20.0±11.0)° vs(43.0±13.0)°.Grip strength was(16.5±3.9)kg preoperatively vs(25.0±8.3)ks postoperatively,while pinch strength was(2.0±0.9)ks vs(3.2±1.3)ks.Krimmer score was(48.0±19.0)preoperatively vs(85.0±23.0)postoperatively.Among those 8 cases,5 were graded as excellent,2 as good and one as fair.DASH score was(52.0±20.0)preoperatively vs(21.0±14.0)postoperatively.The DASH results indicated that dexterity of the hand recovered well but the function of hand was partly limited for heavy labor.Conclusion Trapezium excision combined with flexor carpi radialis suspension is an effective treatment for degenerative arthritis of the first CMC ioint.It can relieve pain and improve function of the first CMC ioint.However,function of the hand is partly limited for heavy labor. Key words: Trapezium bone; Treatment outcome; Carpometacarpal joints; Arthritis