gms | German Medical Science

Objectives/Interrogation: It is not well known whether the degree of shortening of the Trapezial Space Height (TSH) after trapeziectomy for osteoarthritis of thumb trapeziometacarpal joint has any effects on the results. The aims of this study were to assess the pre/postoperative changes of the TSH and the results and investigate the relationship between them.

Methods: This retrospective study was composed of 33 patients (37 hands) who underwent surgical treatment for osteoarthritis of thumb trapeziometacarpal joint, 5 patients (6 hands) of men and 28 patients (31 hands) of women with ages 63 (45 ~ 84). All patients were treated with trapeziectomy and Ligament Reconstruction without Tendon Interposition (LR without TI). The K-wires were inserted to stabilize the thumb for 4 weeks after surgery. We assessed the TSH on the X-ray preoperatively and postoperatively at 2 weeks, after removal of the K-wires, 3 months, 6 months and 12 months. We also assessed pain visual analog scale (VAS) preoperatively and postoperatively at 6 months and 12 months. We investigated the relationship between the TSH and pain VAS.

Results and Conclusions: The preoperative mean TSH was 12.4 mm and the postoperative mean TSH was 8.9 mm at 2 weeks, 6.7 mm after removal of the K-wires, 6.7 mm at 3 months, 6.3 mm at 6 months and 6.1 mm at 12 months. The mean degree of TSH shortening from preoperatively to 2 weeks postoperatively was 3.4mm, from preoperatively to 3 months postoperatively was 5.7 mm and from preoperatively to 12 months postoperatively was 6.3 mm. The preoperative mean pain VAS was 6.2 and the postoperative mean pain VAS was 3.2 at 3 months, 2.1 at 6 months and 1.2 at 12 months. Analysis of the correlation between the TSH and the 12 months postoperative VAS did not show any significant correlation (Pearson correlation coefficient was < .20). Similarly, analysis of the correlation between the degree of shortening of the TSH and the 12 months postoperative pain VAS did not show any significant correlation (Pearson correlation coefficient was < .20).

We concluded that LR without TI not only successfully maintained the Trapezial Space Height without significant shortening after removal of K-wires but also yielded the excellent results. There was no correlation between the pre/postoperative changes of TSH and the results. We expected the cause that we performed ligament reconstruction without any compression or traction to the thumb. Because of theses results we prefer the "in site" ligament reconstruction.