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. 2023 May;18(3):478-483.
doi: 10.1177/15589447211017221. Epub 2021 Jun 2.

Dorsoradial Capsulodesis for Stage I Trapeziometacarpal Joint Arthrosis

Logan R Koehler  1   2 , Ghazi M Rayan  2
Affiliations

Dorsoradial Capsulodesis for Stage I Trapeziometacarpal Joint Arthrosis

Logan R Koehler et al. Hand (N Y). 2023 May.

Abstract

Background: Thumb trapeziometacarpal (TM) joint arthrosis is a common cause of thumb pain, which adversely affects hand function. Early arthrosis is characterized by capsular laxity, painful pinch and grip, and physical findings of joint tenderness and laxity. Dorsoradial capsulodesis (DRC) is a surgical technique used to stabilize the TM joint and treat early-stage arthrosis. We aim to evaluate the clinical outcomes of DRC for treating trapeziometacarpal instability in early-stage disease.

Methods: Between 2003 and 2019, 23 patients underwent DRC. Patients with stage I TM arthritis and more than 6-month postoperative follow-up were included. Pain and disability scores were calculated along with physical examination and radiographic evaluation at the final follow-up.

Results: At mean postoperative follow-up of 43.5 months, 13 patients with a mean age of 39.1 years were examined. The mean Disabilities of the Arm, Shoulder, and Hand score was 5.7, and visual analog pain score was 0.5. Patients had no significant difference in strength or range of motion in the ipsilateral versus contralateral hand. Follow-up radiographs did not demonstrate arthritic changes.

Conclusions: Dorsoradial capsulodesis is a technically simple and reasonable option for stabilizing the TM joint in patients with early-stage arthrosis. This intervention showed no midterm progression to advanced arthritis in this cohort.

Keywords: CMC; Eaton stage 1; anatomy; arthritis; diagnosis; dorsoradial capsulodesis; soft tissue reconstruction; specialty; surgery; thumb; trauma.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A preoperative x-ray of a 39-year-old woman with persistent left trapeziometacarpal joint pain and instability without severe arthritic changes.
Figure 2.
Figure 2.
Postoperative x-rays of the same patient during 4-year follow-up, showing restoration of joint stability without any arthritic changes on PA and Robert views. Note. On examination, her axial rotation test was negative and she had no joint tenderness or pain while using the hand. PA = posterior-anterior.
See this image and copyright information in PMC

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