The Biomechanical Consequences of Trapeziectomy and Partial Trapezoidectomy in the Treatment of Thumb Carpometacarpal and Scaphotrapeziotrapezoid Arthritis

Noor Alolabi, Alexander W. Hooke, Sanjeev Kakar

Research output: Contribution to journalArticle

Abstract

Purpose: To determine, using a biomechanical cadaveric model, whether, in the treatment of thumb carpometacarpal and scaphotrapeziotrapezoid arthritis, partial trapezoid resection following trapeziectomy causes carpal, specifically lunocapitate and scapholunate, instability. Materials and methods: Eight fresh-frozen mid-forearm cadaver specimens with type I lunates and devoid of basilar thumb arthritis were used in the study. Specimens were mounted onto a wrist simulator applying cyclical wrist flexion/extension and radial/ulnar deviation motions. Carpal kinematics, specifically lunocapitate and scapholunate joint relationships, were measured at 4 different conditions: (1) a native intact state, (2) after trapeziectomy, (3) after 2-mm partial trapezoid resection, and (4) after 4-mm partial trapezoid resection. Results: During both flexion/extension and radial/ulnar deviation of the wrist, the lunocapitate and scapholunate joint relationship did not show any notable change following any of trapeziectomy, 2-mm, or 4-mm trapezoid resection compared with the intact state. Changes to the lunocapitate and scapholunate angles were clinically insignificant—a maximum of 6° and 4° change, respectively. Conclusions: This biomechanical cadaveric study shows that performing a trapeziectomy followed by up to 4 mm of proximal trapezoid resection has a negligible effect upon carpal, specifically lunocapitate and scapholunate, stability. Further research is needed to elucidate the long-term clinical consequences of limited trapezoid resection in vivo. Clinical relevance: There may be no clinically relevant effects of resection of up to 4 mm of trapezoid in the surgical management of combined basilar thumb and scaphotrapeziotrapezoid arthritis.

Original languageEnglish (US)
JournalJournal of Hand Surgery
DOIs
StateAccepted/In press - Jan 1 2019

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Keywords

  • carpal instability
  • pantrapezial arthritis
  • thumb arthritis
  • trapeziectomy
  • Trapezoidectomy

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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