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European Journal of Plastic Surgery

, Volume 27, Issue 4, pp 185–193 | Cite as

Dynamic suspension-sling arthroplasty with intermetacarpal ligament reconstruction for the treatment of trapeziometacarpal osteoarthritis

  • Luis R. SchekerEmail author
  • Michael R. Boland
Original Paper
  • 228 Downloads

Abstract

Our new dynamic suspension-sling arthroplasty of the trapeziometacarpal joint stabilizes the base of the first metacarpal after the removal of the trapezium in patients who have trapeziometacarpal joint osteoarthritis. Other techniques involving ligament reconstruction are accompanied by complications such as proximal migration, dorsal subluxation of the first metacarpal base, and impingement of the first and second carpometacarpal joints. In our technique, the first metacarpal is suspended by using a series of tendon loops derived from one-half of the flexor carpi radialis tendon and, therefore, anatomically reconstructs the intermetacarpal and palmar oblique ligaments. From 1988 to 2000, 197 patients (238 thumbs) underwent this procedure. Follow-up was an average of 1.92 years. After surgery, pain decreased, grip strength increased from 24 to 48.7 lb, key pinch increased from 4 to 7.6 lb, and Kapandji scores increased from 6 to 9.3 (averages). Our technique provides an interposition between the bases of the thumb and index metacarpals, resulting in decreased pain, greater strength, and increased flexibility of the trapeziometacarpal joint.

Keywords

Arthroplasty Trapeziometacarpal osteoarthritis Osteoarthritis Dynamic suspension sling arthroplasty 

Notes

Acknowledgment

The authors thank Elaine Bammerlin, MA, CMI, for her superb illustrations.

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Christine M. Kleinert Institute for Hand and Microsurgery225 Abraham Flexner Way Suite 850Louisville

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