Skip to main content

Advertisement

SpringerLink
Log in

Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis?

  • Handsurgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Trapeziometacarpal osteoarthritis sometimes results in hyperextension of the thumb metacarpophalangeal (MCP) joint, which could negatively impact outcomes following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. Although algorithms on performing trapeziectomy with LRTI for the management of this deformity are available, they lack clear evidence. Here, we investigate the function of the thumb MCP joint after trapeziectomy with LTRI and whether this procedure alone corrects preoperative MCP hyperextension, and also analyze clinical factors correlated with MCP hyperextension post-surgery.

Materials and methods

Twenty-eight patients who underwent trapeziectomy with LRTI and followed up for at ≥ 1 year (mean, 27.2 months) were retrospectively analyzed. No patient had concomitant surgery to the thumb MCP joint at the time of trapeziectomy with LRTI. Patients were divided into the < 30° (n = 19) and > 30° (n = 9) hyperextension groups as per their preoperative passive range of motion (ROM) of the MCP joint. Changes in ROM of the MCP joint post-surgery, clinical factors correlated with postoperative MCP hyperextension, and correlations between clinical outcomes and postoperative MCP extension were analyzed.

Results

In the < 30° MCP hyperextension group, active and passive extensions of the MCP joint did not significantly change after surgery, and no worsening of postoperative MCP hyperextension was observed. In the > 30° hyperextension group, passive extension of the MCP joint significantly decreased (mean, 49.6°–29.8°). Preoperative MCP hyperextension improved in seven patients, was unchanged in 1, and worsened in 1. Postoperative passive MCP extension was negatively correlated with active/passive radial abduction, MCP flexion, trapezial space height, subjective outcomes, and hand strength post-surgery.

Conclusions

Trapeziectomy with LRTI alone could prevent postoperative thumb MCP hyperextension deformity for patients with thumb MCP extension < 30° and improve preoperative thumb MCP hyperextension. However, for patients with loss of radial abduction and MCP flexion due to the contracture, indirect correction of the MCP hyperextension was improbable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Berger AJ, Meals RA (2015) Management of osteoarthrosis of the thumb joints. J Hand Surg Am 40(4):843–850

    Article  Google Scholar 

  2. Brogan DM, Kakar S (2012) Metacarpophalangeal joint hyperextension and the treatment of thumb basilar joint arthritis. J Hand Surg Am 37(4):837–838

    Article  Google Scholar 

  3. Moineau G, Richou J, Liot M, Le Nen D (2009) Prognostic factors for the recovery of hand function following trapeziectomy with ligamentoplasty stabilisation. Orthop Traumatol Surg Res 95(5):352–358

    Article  CAS  Google Scholar 

  4. Degeorge B, Dagneaux L, Andrin J, Lazerges C, Coulet B, Chammas M (2018) Do trapeziometacarpal prosthesis provide better metacarpophalangeal stability than trapeziectomy and ligamentoplasty? Orthop Traumatol Surg Res 104(7):1095–1100

    Article  Google Scholar 

  5. Tonkin MA, Beard AJ, Kemp SJ, Eakins DF (1995) Sesamoid arthrodesis for hyperextension of the thumb metacarpophalangeal joint. J Hand Surg Am 20(2):334–338

    Article  CAS  Google Scholar 

  6. Qadir R, Duncan SF, Smith AA, Merritt MV, Ivy CC, Iba K (2014) Volar capsulodesis of the thumb metacarpophalangeal joint at the time of basal joint arthroplasty: a surgical technique using suture anchors. J Hand Surg Am 39(10):1999–2004

    Article  Google Scholar 

  7. Lourie GM (2001) The role and implementation of metacarpophalangeal joint fusion and capsulodesis: indications and treatment alternatives. Hand Clin 17(2):255–260

    Article  CAS  Google Scholar 

  8. Kessler I (1979) A simplified technique to correct hyperextension deformity of the metacarpophalangeal joint of the thumb. J Bone Jt Surg Am 61(6A):903–905

    Article  CAS  Google Scholar 

  9. Miller NJ, Davis TR (2014) Palmar plate capsulodesis for thumb metacarpophalangeal joint hyperextension in association with trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 39(3):272–275

    Article  CAS  Google Scholar 

  10. Eaton RG, Floyd WE (1988) Thumb metacarpophalangeal capsulodesis: an adjunct procedure to basal joint arthroplasty for collapse deformity of the first ray. J Hand Surg Am 13(3):449–453

    Article  CAS  Google Scholar 

  11. Hess DE, Drace P, Franco MJ, Chhabra AB (2018) Failed thumb carpometacarpal arthroplasty: common etiologies and surgical options for revision. J Hand Surg Am 43(9):844–852

    Article  Google Scholar 

  12. Klinefelter R (2011) Metacarpophalangeal hyperextension deformity associated with trapezial-metacarpal arthritis. J Hand Surg Am 36(12):2041–2042 (quiz 2043)

    Article  Google Scholar 

  13. Hartigan BJ, Stern PJ, Kiefhaber TR (2001) Thumb carpometacarpal osteoarthritis: arthrodesis compared with ligament reconstruction and tendon interposition. J Bone Jt Surg Am 83(10):1470–1478

    Article  CAS  Google Scholar 

  14. Rizzo M, Moran SL, Shin AY (2009) Long-term outcomes of trapeziometacarpal arthrodesis in the management of trapeziometacarpal arthritis. J Hand Surg Am 34(1):20–26

    Article  Google Scholar 

  15. Kazmers NH, Hippensteel KJ, Calfee RP, Wall LB, Boyer MI, Goldfarb CA et al (2017) Locking plate arthrodesis compares favorably with LRTI for thumb trapeziometacarpal arthrosis: early outcomes from a longitudinal cohort study. HSS J 13(1):54–60

    Article  Google Scholar 

  16. Hayashi M, Uchiyama S, Nakamura K, Itsubo T, Momose T, Kato H (2015) Arthrodesis of the carpometacarpal joint of the thumb with plate fixation and bone grafting: a retrospective review. J Orthop Sci 20(2):302–306

    Article  Google Scholar 

  17. Jiménez-Díaz V, Cecilia-López D, Porras-Moreno M, Muñoz-Sánchez G, García-Lamas L, Jara-Sánchez F (2017) Arthrodesis of the thumb carpometacarpal joint using a quadrangular plate: surgical technique and long-term results of 70 patients. Eur J Orthop Surg Traumatol 27(7):909–915

    Article  Google Scholar 

  18. Eaton RG, Glickel SZ (1987) Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment. Hand Clin 3(4):455–471

    Article  CAS  Google Scholar 

  19. Komura S, Hirakawa A, Masuda T, Nohara M, Kimura A, Matsushita Y et al (2020) Chronological changes in surgical outcomes after trapeziectomy with ligament reconstruction and tendon interposition arthroplasty for thumb carpometacarpal osteoarthritis. Orthop Traumatol Surg Res 106(2):357–364

    Article  Google Scholar 

  20. Suzuki M, Kurimoto S, Shinohara T, Tatebe M, Imaeda T, Hirata H (2010) Development and validation of an illustrated questionnaire to evaluate disabilities of the upper limb. J Bone Jt Surg Br 92(7):963–969

    Article  CAS  Google Scholar 

  21. Bhat M, Davis TR, Bannerjee A (2003) Trapezial space height measurement after trapeziectomy: a comparison of the use of standard and stress radiographs. J Hand Surg Am 28(3):390–396

    Article  Google Scholar 

  22. Brogan DM, van Hogezand RM, Babovic N, Carlsen B, Kakar S (2017) The effect of metacarpophalangeal joint hyperextension on outcomes in the surgical treatment of carpometacarpal joint arthritis. J Wrist Surg 6(3):188–193

    Article  Google Scholar 

  23. Poulter RJ, Davis TR (2011) Management of hyperextension of the metacarpophalangeal joint in association with trapeziometacarpal joint osteoarthritis. J Hand Surg Eur Vol 36(4):280–284

    Article  CAS  Google Scholar 

  24. Hamada Y, Kobayashi A, Sairyo K, Sato R, Hibino N (2015) Correction of a hyperextension deformity at the metacarpophalangeal joint by arthroplasty for osteoarthritis of the thumb carpometacarpal joint followed by external fixator: a case series: modified ilizarov method for correction of a collapsed thumb deformity due to carpometacarpal osteoarthritis. J Hand Microsurg 7(1):67–72

    Article  Google Scholar 

Download references

Acknowledgements

The authors report no benefits, grants, or assistance from any party.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Yanagido 1-1, Gifu, 501-1194, Japan

    Shingo Komura, Akihiro Hirakawa & Haruhiko Akiyama

  2. Department of Rehabilitation Medicine, Gifu University Hospital, Gifu, Japan

    Tomihiro Masuda, Marie Nohara, Ayaka Kimura & Yasuharu Matsushita

Authors
  1. Shingo Komura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Akihiro Hirakawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tomihiro Masuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie Nohara
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayaka Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yasuharu Matsushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haruhiko Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SK and AH designed the study and performed operation. TM, MN, AK and YM performed rehabilitation and measured objective data. SK and HA analyzed the data and wrote the manuscript.

Corresponding author

Correspondence to Shingo Komura.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This retrospective study was approved by the institutional review board of Gifu University Graduate School of Medicine (2018-217).

Informed consent

Informed consent was obtained from the patients.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 30 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Komura, S., Hirakawa, A., Masuda, T. et al. Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis?. Arch Orthop Trauma Surg 141, 1261–1268 (2021). https://doi.org/10.1007/s00402-021-03838-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-021-03838-8

Keywords

Search

Navigation