Abstract
Purpose
Treating arthrosis in the base of the thumb has been a highly controverted subject.
Many surgeries have been described, such as the isolated trapezium resection; resection
with interposition with and without ligament plasty; arthrodesis, and arthroplasties.
The purpose of this paper is to compare the two techniques which are currently the
most used in this treatment.
Methods
A prospective study has been made to compare the surgical results between the trapezium
resection with tendon interposition (tenoarthroplasty) – 22 cases – and tenoarthroplasty
associated to ligament plasty—24 cases. Objective evaluation was done by measuring
opponence, movements of the metacarpophalangeal joint, pinch and grasp strength, radiographic
measurement of the distance between the base of first metacarpal and the scaphoid,
and measurement of the angle between the first and the second metacarpals. Subjective
evaluation was done with a DASH questionnaire, visual analog scale to evaluate pain
and patient satisfaction.
Results and conclusion
After application of the criteria described and using Student ‘t’ tests for statistical analysis, the authors concluded that the ligament reconstruction
has no advantage over the simple resection and tendon interposition in carpometacarpal
arthrosis of the thumb.
Keywords Osteoarthritis - Trapezium bone surgery - Thumb pathology - Musculoskeletal diseases
surgery - Arthroplasty methods - Comparative studies
