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. 2023;11(1):68-71.
doi: 10.22038/ABJS.2022.64493.3100.

Volar Plate Advancement and Abductor Pollicis Brevis Tenodesis for Thumb Metacarpophalangeal Joint Hyperextension Correction

Teun Teunis  1 , Sonya Khurana  2 , Joseph E Imbriglia  3
Affiliations

Volar Plate Advancement and Abductor Pollicis Brevis Tenodesis for Thumb Metacarpophalangeal Joint Hyperextension Correction

Teun Teunis et al. Arch Bone Jt Surg. 2023.

Abstract

First carpometacarpal (CMC1) osteoarthritis can be accompanied by the collapse of the first ray, with hyperextension of the first metacarpophalangeal (MCP1) joint. It is suggested that failure to address substantial MCP1 hyperextension during CMC1 arthroplasty may diminish post-operative capability and increase collapse reoccurrence. An arthrodesis is recommended in case of severe MCP1 joint hyperextension (>400). We describe a novel combination of a volar plate advancement and abductor pollicis brevis tenodesis to address MCP1 hyperextension at the time of CMC1 arthroplasty as an alternative to joint fusion. In 6 women, mean MCP1 hyperextension with pinch before surgery was 450 (range 300-850) and improved to 210 (range 150-300) of flexion with pinch six months after surgery. No revision surgery has been necessary to date, and there were no adverse events. Long-term outcome data is needed to establish the longevity of this procedure as an alternative to joint fusion, but early results are promising.

Keywords: ABP tenodesis; Basal joint arthritis; CMC1 arthritis; MCP1 hyperextension; Volar plate advancement.

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Figures

Figure 1
Figure 1
Radiograph of the collapse of the first ray in severe first carpometacarpal osteoarthritis
Figure 2
Figure 2
Drawing of the thumb metacarpal and phalanges
Figure 3
Figure 3
Surgical technique in a cadaver
Figure 4
Figure 4
See this image and copyright information in PMC

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