Is there a role for hemitrapeziectomy in ligament reconstruction or tendon interposition procedures?

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Abstract

Purpose of review

There are many possible surgical treatments for thumb trapeziometacarpal osteoarthritis, and the decision regarding trapezial preservation or excision varies widely. This review is designed to look at the merits and pitfalls of maintaining, partially resecting, or completely excising the trapezium while performing ligament reconstruction or tendon interposition procedures.

Recent findings

In recent years, several authors have reported overall reasonable results with techniques that either excise the entire trapezium or preserve a portion thereof when performing ligament reconstruction or tendon interposition procedures. Studies have explored these outcomes with regards to function, pain relief, postoperative strength, and operative simplicity, and there is a role for each of the procedures.

Summary

In traditional open procedures for ligament reconstruction or tendon interposition, performing a complete trapeziectomy affords excellent visualization and working space, and is a simple reproducible procedure. Partial trapeziectomy may have its most valuable role in arthroscopic approaches involving tendon interposition to the trapeziometacarpal joint.

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