gms | German Medical Science

Objectives/Interrogation: Trapeziectomy remains gold standard in treatment of basal thumb arthritis. This presentation handles the technique of costal cartilage interposition arthroplasty with special attention to the additional arthritis of the scaphotrapezoidal joint.

Methods: The main agenda of the presentation is to primarily focus on 26 patients afflicted by the disease who, according to Eaton-Littler classification, were categorized as stage IV, and who from 2015 on were treated with trapeziectomy, costochondral autograft and ligament reconstruction. Surgery was performed with additional interposition arthroplasty of the scaphotapezoidal joint with a cartilage chip. Thumb and wrist were immobilized postoperatively for 4 weeks in a spika type cast/orthosis. The results were assessed by Buck-Gramco scale after 14-36 months.

Results and Conclusions: In total we could assess well or very well 20 patients. Radiologically there was no migration of thumb metacarpal in any of the patients. The vitality of costal cartilage was evidenced in MRI performed on random patients, which further more demonstrated the correct position of the cartilage chip.

Since 1995 interposition arthroplasty with costal cartilage in basal thumb arthritis has been performed with generally very good results.

The special attention to the scaphotrapezoidal joint seems to be reasonable and the interposition of a cartilage chip appears to be a suitable solution.