Suspension Arthroplasty
(Trapezectomy with LRTI (Ligament Reconstruction and Tendon Interposition))
Problem
- Pain at the base of the thumb
Cause
- Osteoarthritis at the CMC (carpometacarpal) joint.
Diagnosis
- Pain at the base of the thumb
- Weakness with key and pinch grip, difficulty opening jars, and turning keys.
- “Shouldering” deformity at the base of the thumb
- Positive grind test on moving thumb
- X-rays confirm the osteoarthritis.
Treatment
Non Op
- NSAIDS, splints, steroid injections.
Operative
- Early – Corrective Osteotomy. Realigns the bone and unloads the joint.
- Late – Trapezectomy with LRTJ
- GA
- Day Surgery or one night stay
- Trapezectomy, remove the arthritic bone
- LRTJ, stabilize the thumb using spare local tendon
Potential Complications
- Infection, Haematoma, and Stiffness
- Numbness over base of thumb
- Migration of the thumb metacarpal
Post Op Care
- Plaster for 2 weeks
- Review at 2 weeks and into splint for further 4 weeks
- Start movement at 4 weeks
- Clinical review at 2 weeks, 6 weeks and 3 months
- Hand therapy for 3 months
- Takes about 3 months to recover from the operation
