TO SUSPEND OR NOT SUSPEND - THAT IS THE QUESTION. A RANDOMISED, CONTROLLED AND BLINDED STUDY OF TRAPEZIECTOMY ALONE VERSUS TRAPEZIECTOMY + FCR SUSPENSION.

Abstract

Introduction: Osteoarthritis of the thumb is the second most common site of arthritis in humans. There are numerous operations for the condition, but perhaps the commonest is trapeziectomy, which can be supplemented with a suspension procedure generally using FCR.

It was the aim of this study to determine whether there is an advantage of one procedure over the other.

Materials and methods: 60 patients with either Eaton and Littler grade III or IV arthritis of the CMCJ of their thumbs were randomised into either having a traditional trapeziectomy (with no wiring), or a trapeziectomy with FCR suspension. The surgery was performed by the senior surgeon. All patients were assessed pre- and post operatively (at 3,6 and 12 months) by a physiotherapist measuring pain on visual analogue scores doing various activities, range of movement and grip and pinch strength. X-rays were taken at the same intervals.

Results: Patient satisfaction from both operations was similar. There was no significant difference between visual analogue scores. Measurement of the gap left by the trapeziectomy was less when trapeziectomy alone was performed.

Discussion: There is no obvious difference in the results of these two surgical techniques for treating OA of thumb CMCJ. It is not necessary to perform the FCR suspension.