Table of Contents
Advances in Orthopedic Surgery
Volume 2014, Article ID 910257, 5 pages
http://dx.doi.org/10.1155/2014/910257
Clinical Study

Arthrodesis of the Trapeziometacarpal Joint Using a Chevron Osteotomy and Plate Fixation

1Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, West Midlands B9 5SS, UK
2Worthing Hospital, Lyndhurst Road, Worthing, West Sussex BN11 2DH, UK

Received 1 June 2014; Revised 2 October 2014; Accepted 2 October 2014; Published 22 October 2014

Academic Editor: Padhraig O’Loughlin

Copyright © 2014 G. Shyamalan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Trapeziometacarpal (TM) osteoarthritis is common. Despite the availability of numerous surgical options, none has been definitively proven to be superior. This study aims to determine the union rate and key strength following arthrodesis using a chevron osteotomy and plate fixation. Methods. 32 consecutive cases of TM joint arthrodesis performed between 2001 and 2006 were retrospectively identified. A chevron osteotomy was used to resect joint surfaces and fixation obtained using an AO mini T-plate. The patients were followed up for a mean of 65 months. Outcomes included visual analogue pain score, patient satisfaction, pinch strength, radiographic union, radiographic signs of scaphotrapezial arthritis, and complications. Results. The 32 cases included 16 females and 8 males with an average age of 56 years. Overall there was a 90% patient satisfaction rate. Average key pinch strength was 8.4 kg and pain score was 2.5. The union rate was 94%, and the two patients with nonunion underwent successful revision surgery. Only one case of radiographic progression of scaphotrapezoid arthritis was identified during followup. Conclusion. TM joint arthrodesis using a chevron osteotomy and plate fixation has high patient satisfaction and low nonunion rates. The authors endorse this technique in the management of TM joint osteoarthritis.