The results of trapeziectomy and tendon interposition/ suspansion arthroplasty in first carpometacarpal joint osteoarthrosis

ABSTRACT The carpometacarpal (CMC) joint of the first finger which is sellar in shape that leads to a great range of motion, has a really important and characteristic function on human hand's dexterity of grip. This joint that is at the very base of the thumb is exposed to a variety of physical stresses life long. Conditions like osteoarthrosis, rheumatoid arthritis, postmenapausal laxity of the capsular ligamentous structures may cause subluxation and further dislocation of this important joint surfaces, by the change of the rotational arc's and appearence of abnormal affects of muscle forces, the arthrosis process becomes inevitable. First CMC joint osteoarthrosis is frequently encountered in daily orthopaedics clinic and this pathology comes forward being seen especially in postmenapausal women. The radiographic osteoarthrosis prevelance in postmenapausal women is as high as 33% while it's reported as 7% in men. Although the mean surgery age for first carpometacarpal osteoarthrosis is 60, the incidence of the surgery performed on men is more than the radiographic incidence. In this study, the results of the trapeziectomy and tendon interposition/suspension arthroplasty operation were evaluated retrospectively with a case control study, the evaluation consisting of general data, range of motion, grip strength evaluation, pain and satisfaction score analysis. As a result of this study, for its properties like 82 % decrease in pain, satisfactory range of motion preservation by 15,2% flexion loss, 19,7%extansion loss, 6,9% abduction loss and 71% to 105% maintanence of grip strength with analisation of different groups, this operation is found to be a highly effective and valid treatment method, when it is performed on true indications, in painful first CMC joint osteoarthrosis. Keywords: First carpometacarpal joint, Rhizartosis, Trapeziectomy, Ligament Reconstruction and Tendon İnterposition, Suspensionplasty.