Purpose Statement

To evaluate a modified technique in carpometacarpal arthroplasty utilizing interosseous permanent suture fixation of the abductor pollicis longus muscle as an interposition arthroplasty.

Methods and Materials

A retrospective chart review yielded 35 procedures performed on 33 patients from 2000 to 2003. All patients returned for routine follow-up visits which averaged 11.05 months and included physical examination, radiographs, and subjective questioning regarding function, pain, and satisfaction with the procedure. The physical examination consisted of scar quality, range of motion, and grip/pinch strength determination.

Results

Scar quality was excellent in 33/35 patients or 94.3% on follow-up with all patients developing satisfactory scars. Opposition was assessed in all patients and was good in 100% (opposition to the base of the 4th proximal phalynx), and excellent (opposition to base of 5th proximal phalynx) in 91.4%. Key pinch ranged from 4.3 to 5.1 kg and mean grip strength from 18 to 28 kg. Radiographically, 100% of patients maintained a satisfactory scaphometacarpal interval even under loaded pinch. Subjectively, satisfactory pain relief was reported in 33/35 patients or 94.3%.

Conclusion

Carpometacarpal arthroplasty utilizing interosseous permanent suture fixation of the abductor pollicis longus has shown good results in this follow-up interval.