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. 2020 Dec 30;91(14-S):e2020026.
doi: 10.23750/abm.v91i14-S.10976.

Trapezio-metacarpal arthritis: functional and radiographic results at an average 5-year follow-up using trapeziectomy associated to a modified Ceruso's suspensionplasty

Chiara Concina  1 , Marina Crucil  2 , Giorgio Saggin  3 , Franco Gherlinzoni  4
Affiliations

Trapezio-metacarpal arthritis: functional and radiographic results at an average 5-year follow-up using trapeziectomy associated to a modified Ceruso's suspensionplasty

Chiara Concina et al. Acta Biomed. .

Abstract

Background and aim: Trapezial-metacarpal arthritis (TMA) is a common and highly disabling pathology. Trapeziectomy and Ceruso's suspensionplasty is described for moderate-severe stages. The aim of the present study was to assess functional and radiographic results at an average 5-year follow-up using a modified Ceruso's technique where the Abductor Pollicis Longus (APL) is passed twice around the Flexor Carpi Radialis (FCR) and a suture mini-anchor in the base of the first metacarpal is used to further stabilize the thumb.

Methods: 85 consecutive modified Ceruso's suspensionplasty were performed from 2012 and 2018. All the patients were evaluated at an average 5.1-year follow-up (21-96 months). Subjective patient satisfaction rate, NRS, DASH score, abduction angle, Kapandji score and pinch strength using functional tests were assessed. The scapho-metacarpal distance was measured at follow-up radiographs.

Results: 90.6% of the patients were satisfied by the treatment. The NRS and the DASH score improved (from 8.5 pre-operatively to 1.53 and from 87.5 to 24.6 respectively-p<0.001). The Kapandji test was rated from 7 to 10 in 65.9% of the patients. The pinch strength was good in 75.3% of the patients at follow-up. The abduction angle of the thumb was 38.2° (20°-55°). The mean scapho-trapezial distance decreased of 2.45 mm (from 9.87 mm to 7.42 mm - p<0.05). 8 patients had persistent pain and thumb disfunction, 1 patient had De Quervain's tenosynovitis.

Conclusions: Suspensionplasty according to Ceruso's is a relatively simple and reproducible technique for moderate-severe TMA. It improves pain and thumb function, giving good stability without significant shortening.

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Conflict of interest statement

Each author declares that he or she has no commercial associations (e.g. consultancies, stock ownership, equity interest, patent/licensing arrangement etc.) that might pose a conflict of interest in connection with the submitted article

Figures

Figure 1.
Figure 1.
a) Identification of the trapezio-metacarpal joint; b) the retractor shows the FCR tendon; c) the retractor shows the base of the first metacarpal; d) the APL tendon is identified and e) its dorsal part is harvested; f) Spongostan fills the trapezial gap.
Figure 2.
Figure 2.
The Kapandji score in our patients.
Figure 3.
Figure 3.
65-year old woman; stage IV according to Eaton and Littler classification (7); the operation restored the length and brought the first metacarpal close to the second one.
Figure 4.
Figure 4.
64 year-old woman; stage II according to Eaton and Littler classification (7). The scapho-trapezial distance is maintained at 5-year follow-up.
See this image and copyright information in PMC

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