Trapeziectomy With Ligament Reconstruction and Tendon Interposition Arthroplasty With the Entire Width of the Flexor Carpi Radialis Tendon

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Trapeziectomy With Ligament Reconstruction and Tendon Interposition Arthroplasty With the Entire Width of the Flexor Carpi Radialis Tendon

By Marco Paterlini

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May 9, 2016

The original Burton-Pellegrini technique used to treat trapeziometacarpal joint osteoarthritis suggests the use of half ...
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flexor carpi radialis (FCR) width to reconstruct the ligament and perform
the tendon interposition arthroplasty. In our study, unlike the
original technique, we used the full thickness of the FCR and evaluated
a sample of 100 thumbs (95 patients) preoperatively and postoperatively,
with a mean follow-up of 36 months. According to the
Eaton classification, 1 thumb was grade II, 81 were grade III, and 18
were grade IV. The mean patient age at the time of surgery was 62.4
years. The finger-tip pinch improved by 46.3%, the key pinch
improved by 34.5%, the grip strength improved by 50.8%, and the
Kapandji test improved by 7.4%. Pain measured with visual analog
score improved by 78.8%. The self-administrated questionnaires
DASH and PRWHE were completed postoperatively from 2006 to
2012, because the Italian version of PRWHE was not yet validated: the
postoperative DASH and PRWHE were, respectively, 9.9 and 10.5. No
complications such as metacarpal subluxation of the thumb, impingement,
fracture of the first metacarpal base, or a decrease in the wrist
function were found in our population after surgical treatment.
Therefore, according to our series, this variation of the original Burton-
Pellegini surgical technique provides pain relief, stability, and mobility
of the thumb without any morbidity caused by the full harvest of the
FCR tendon.
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