Document Detail

Trapezial space height after trapeziectomy: mechanism of formation and benefits.
MedLine Citation:
PMID:  11561239     Owner:  NLM     Status:  MEDLINE    
Seventy-three thumbs in 67 women with osteoarthritis of the trapeziometacarpal joint were assessed prospectively. The patients were randomly allocated for treatment by either trapeziectomy alone (n = 26) or trapeziectomy with tendon interposition (n = 23) or ligament reconstruction (n = 24). A K-wire was passed through the thumb metacarpal base and across the trapezial space into the distal pole of the scaphoid in all procedures; this held the base of the metacarpal away from the scaphoid for 4 weeks. Standard thumb radiographs were used to calculate the trapezial space ratio before surgery and at 1-year follow-up examination. The trapezial space ratio decreased significantly from a preoperative mean of 0.40 (range, 0.20-0.56) to a mean of 0.18 (range, 0.08-0.30) after trapeziectomy, 0.16 (range, 0.07-0.30) after trapeziectomy with tendon interposition, and 0.20 (range, 0.00-0.33) after trapeziectomy with ligament reconstruction. There was no significant difference between these 1-year follow-up trapezial space ratios, suggesting that the placement of a K-wire across the trapezial void is as effective as tendon interposition or ligament reconstruction in creating a trapezial space in the short term at least. However, the need to create a trapezial space and maintain thumb length is questioned because the trapezial space height did not correlate with thumb strength at 1-year follow-up examination.
N D Downing; T R Davis
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  26     ISSN:  0363-5023     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-18     Completed Date:  2001-10-18     Revised Date:  2009-06-08    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  862-8     Citation Subset:  IM    
Department of Trauma and Orthopaedic Surgery, Queen's Medical Centre, University Hospital, Nottingham, England.
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MeSH Terms
Finger Joint / radiography,  surgery*
Ligaments, Articular / surgery*
Orthopedic Procedures*
Osteoarthritis / surgery*
Tendons / transplantation*
Thumb / radiography,  surgery*

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