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CPD/CME Points: 1
This is a detailed step by step instruction through a Trapeziectomy through a dorsal approach without any sling or ligament interposition procedure.
This is a resection procedure for arthritis of the 1st Carpo-metacarpal joint (CMCJ) plus or minus associated Scapho-trapezio-trapezoid (STT) arthritis due to osteoarthritis, inflammatory arthritis or post-traumatic arthritis.
This procedure is performed under an axillary block with an upper arm tourniquet, patient supine and take between 30-45 minutes.
Following a period of 2 weeks in plaster cast and 4 weeks in a removable splint and hand therapy the patient is expected to be much more comfortable using their hand however the pain reduction and strengthening often continue to improve up to 6 months post-procedure.
The procedure can be complicated by excessive 1st metacarpo-phalangeal joint (MCPJ) hyperextension which will be discussed in more detail in the indications section.
Author: Mr Mark Brewster FRCS (Tr & Orth)
Institution: The Royal Orthopaedic Hospital, Birmingham ,UK.