Technical trick in suture-button suspensionplasty for the treatment of thumb carpometacarpal arthritis

Abstract

Suture-button suspensionplasty has been popularized in the treatment of thumb carpometacarpal (CMC) arthritis in recent years. The surgical technique of this method was well defined previously. The most challenging and important part of this technique is the tensioning of the suture-button system to preserve first metacarpal height after trapeziectomy. In present study, we would like to present a technical trick about adjusting the tension while performing suspensionplasty using suture-button device in thumb CMC joint osteoarthritis. In the original technique, trapeziectomy is performed prior to fixation and tensioning of suture-button system. However, it is quite difficult to recreate the original trapezial space, since first metacarpal subsides after trapeziectomy. The trick in our technique is that trapezium remains in its anatomic position up to the end of the operation. Thus, we do not need to make effort to adjust the thumb ray height and use fluoroscopic imaging to ensure its position. In conclusion, we believe that our technique simplifies the most challenging part of the operation, shortens the operation time, preserves the original first ray height and diminishes the exposure of ionizing radiation as it reduces the need for fluoroscopy.

Zusammenfassung

Die Suture-button-Resektionssuspensionsarthroplastik für die Behandlung der Daumensattelgelenksarthrose erfreut sich seit ihrer Einführung einer gewissen Beliebtheit. Allerdings ist es schwierig die Spannung des Suture-button-Systems so einzustellen, dass eine Proximalisierung des ersten Mittelhandknochens sicher vermieden wird. Wir haben eine Technik entwickelt, die dies erleichtert. Dabei wird im Gegensatz zur Originaltechnik die Resektion des Trapeziums nicht zu Beginn der Operation durchgeführt, sondern erst nach Einbringen des Suture-button-Systems.

Key words

Rhizarthrosis - thumb CMC osteoarthritis - suture-button-suspensionplasty

Schlüsselwörter

Rhizarthrose - Daumensattelgelenksarthrose - Suture-button-Suspensionsarthroplastik

Publication History

Received: 20 October 2020

Accepted: 09 December 2020

Article published online:
01 February 2021

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