Speaker: Supplement carpometacarpal arthroplasty with metacarpophalangeal fusion
Click Here to Manage Email Alerts
Key takeaways:
- Patients who underwent carpometacarpal arthroplasty with metacarpophalangeal fusion had strong pinch strength.
- Researchers recommend supplementing carpometacarpal arthroplasty with metacarpophalangeal fusion.
LAS VEGAS — According to presented results, patients who underwent carpometacarpal arthroplasty with metacarpophalangeal fusion had stronger pinch strength compared with patients who underwent carpometacarpal arthroplasty alone.
“Patients with [metacarpophalangeal] MP hyperextension greater than 30° and patients with thenar atrophy both have dysfunctional pinch mechanics. Those with MP hyperextension collapse during pinch and those with thenar atrophy rotate into abduction,” Carissa C. Dock, BS, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “Both of these can be devastating because they affect the stability of both the MP and [carpometacarpal] CMC joints resulting in a weak, nonfunctional pinch,” she said.
Dock and colleagues retrospectively reviewed data for 90 patients (average age of 67.3 years) who underwent a total of 53 CMC arthroplasties and 60 CMC arthroplasties with MP fusions. Average follow-up was 5.9 years. According to the study abstract, CMC arthroplasty consisted of a trapezial excision, abductor pollicis longus suspension sling and cadaveric fascia lata graft interposition, while CMC arthroplasty and MP fusion consisted of clip staples and a trapezial bone graft. Outcomes included QuickDASH scores, VAS pain scores and pinch strength scores from both thumbs.
Researchers found patients who underwent CMC arthroplasty and MP fusion had a significantly stronger pinch strength (12.7 pounds) compared with patients who had CMC arthroplasty alone (10.9 pounds) and the unoperated thumbs (10.8 pounds). QuickDASH and VAS scores were similar among the cohorts.
“Based on this, we recommend expanding criteria for CMC [and] MP fusion to include those with moderate to severe thenar atrophy,” Dock concluded.
Collapse
Dock CC, et al. Paper 045. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 7-11, 2023; Las Vegas.
Read more about
Click Here to Manage Email Alerts