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
