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Arch Hand Microsurg > Volume 22(2); 2017 > Article
Journal of the Korean Society for Surgery of the Hand 2017;22(2):81-88.
Published online June 30, 2017.
DOI: https://doi.org/10.12790/jkssh.2017.22.2.81   
Evaluation of Anti-Subsidence Effect of Abductor Pollicis Longus Suspensionplasty in Carpometacarpal Arthritis of the Thumb
Jung Woo Park, Hyun Dae Shin, Soo Min Cha
Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea. hyunsd@cnu.ac.kr
Received: 21 December 2016   • Revised: 2 February 2017   • Accepted: 12 February 2017
Abstract
Purpose
To evaluate the anti-subsidence effect of suspensionplasty using abductor pollicis longus (APL) tendon in carpometacarpal (CMC) arthritis of the thumb.

Methods
From June 2009 to May 2016, hematoma distraction arthroplasty (HDA; group A, 10 cases) and HDA with suspensionplasty using APL tendon (group B, 7 cases) were performed in total 17 patients with CMC arthritis. The K-wire was fixed from 1st metacarpal to 2nd metacarpal in both group to maintain the empty space for 6 weeks until the fibrous tissue fill the space. We measured the preoperative trapezium space height with picture archiving and communication (PACS) system and compare the height with that was measured postoperatively. Additionally the subsidence rate checked sequentially with follow-up plain radiography.

Results
The subsidence ratios (subsidence/trapezium height) were average 33.2% in group A and 31.4% in group B. There is no statistical difference between two groups. Six weeks after pin removal almost of subsidence occurred, and then from 3 months after surgery to 6 months after surgery, few subsidence was occurred and it is average only 8% of total subsidence. The trial of distraction the empty space when perform the Kirschner wire (K-wire) fixation, it does not influence the prevention of subsidence. Between distraction height and subsidence, there was no statistical relevance.

Conclusion
Although suspensionplasty was known as one of methods to prevent the subsidence, it is thought to be not very helpful method to prevent subsidence of thumb in CMC arthritis.
 
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