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Suture button suspensionplasty had superior outcomes vs other techniques

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LAS VEGAS — Results presented at the American Society for Surgery of the Hand Annual Meeting showed thumb carpometacarpal Mini TightRope (Arthrex) suture button suspensionplasty following trapeziectomy led to less subsidence and better functional outcomes compared with flexor carpi radialis and abductor pollicis longus suspensionplasties.

Among 112 patients with Eaton stage III or IV thumb carpometacarpal arthritis who underwent open trapeziectomy and suspensionplasty after 6 weeks of failed conservative management, Owolabi A. Shonuga, MD, and colleagues collected QuickDASH questionnaires, VAS for pain and lateral pinch strength preoperatively and at 2 weeks, 3 months and 1 year postoperatively, as well as complications.

Results showed 19 patients underwent flexor carpi radialis (FCR) suspensionplasty, 34 patients underwent abductor pollicis longus (APL) suspensionplasty and 59 patients underwent Mini TightRope suture button suspensionplasty. Shonuga reported no preoperative differences in the trapeziometacarpal index between the TightRope suspensionplasty group and the FCR and APL suspensionplasty groups.

“However, postoperatively at 2 weeks and 3 months, there was significant difference and the TightRope suture button group had significantly less subsidence than the APL/FCR group,” Shonuga said in his presentation here.

He added that the difference between the groups normalized at 1 year. Although the groups had no preoperative differences in terms of functionality, according to Shonuga, the TightRope group showed significantly better functional outcomes at all postoperative time points.

“In terms of pain, there was no difference between the [TightRope and APL/FCR] groups at all time points except for 1 year. In terms of pinch strength, there was no difference between the two groups at all time points,” Shonuga said. – by Casey Tingle

Reference:

Shonuga OA, et al. Abstract 54. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 5-7, 2019; Las Vegas.

Disclosure: Shonuga reports no relevant financial disclosures.