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Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis.

Lee HJ, Kim PT, Deslivia MF, Jeon IH, Lee SJ, Nam SJ - Clin Orthop Surg (2015)

Bottom Line: All patients showed decreased VAS from 7.2 to 1.7.The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8.The height of the space decreased from 10.8 to 7.1 mm.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.

ABSTRACT

Background: Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty.

Methods: The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs.

Results: The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously.

Conclusions: The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results.

No MeSH data available.


Related in: MedlinePlus

The abductor pollicis longus (APL) slip was wrapped two or three times around the flexor carpi radialis tendon to make a hammock, which suspended the base of the first metacarpal bone. The most distal end of the APL was put into the trapezial space after being fixed to the dorsal capsule.
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Figure 1: The abductor pollicis longus (APL) slip was wrapped two or three times around the flexor carpi radialis tendon to make a hammock, which suspended the base of the first metacarpal bone. The most distal end of the APL was put into the trapezial space after being fixed to the dorsal capsule.

Mentions: The APL slip was wrapped two or three times around the FCR tendon to make a hammock, which suspends the base of the first metacarpal bone; this prevents the proximal migration of the first metacarpal bone (Fig. 1). While the end of the APL slip was pulled tightly, two sutures of 3-0 prolene were passed through the crossed APL and FCR tendon bundle. Maintaining the tension of the APL, the end of the APL was stitched to the base of the first metacarpal bone with 3-0 absorbable vicryl suture material so that the first metacarpal base was suspended as far distally as possible. The remaining end of the APL slip was packed into the trapezial space. The dorsal capsule over the trapezial space was then closed.


Results of Abductor Pollicis Longus Suspension Ligamentoplasty for Treatment of Advanced First Carpometacarpal Arthritis.

Lee HJ, Kim PT, Deslivia MF, Jeon IH, Lee SJ, Nam SJ - Clin Orthop Surg (2015)

The abductor pollicis longus (APL) slip was wrapped two or three times around the flexor carpi radialis tendon to make a hammock, which suspended the base of the first metacarpal bone. The most distal end of the APL was put into the trapezial space after being fixed to the dorsal capsule.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553287&req=5

Figure 1: The abductor pollicis longus (APL) slip was wrapped two or three times around the flexor carpi radialis tendon to make a hammock, which suspended the base of the first metacarpal bone. The most distal end of the APL was put into the trapezial space after being fixed to the dorsal capsule.
Mentions: The APL slip was wrapped two or three times around the FCR tendon to make a hammock, which suspends the base of the first metacarpal bone; this prevents the proximal migration of the first metacarpal bone (Fig. 1). While the end of the APL slip was pulled tightly, two sutures of 3-0 prolene were passed through the crossed APL and FCR tendon bundle. Maintaining the tension of the APL, the end of the APL was stitched to the base of the first metacarpal bone with 3-0 absorbable vicryl suture material so that the first metacarpal base was suspended as far distally as possible. The remaining end of the APL slip was packed into the trapezial space. The dorsal capsule over the trapezial space was then closed.

Bottom Line: All patients showed decreased VAS from 7.2 to 1.7.The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8.The height of the space decreased from 10.8 to 7.1 mm.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.

ABSTRACT

Background: Suspension ligamentoplasty using abductor pollicis longus (APL) tendon without bone tunneling, was introduced as one of the techniques for treatment of advanced first carpometacarpal (CMC) arthritis. The purpose of this study was to evaluate the radiologic and clinical results of APL suspension ligamentoplasty.

Methods: The medical records of 19 patients who underwent APL suspension ligamentoplasty for advanced first CMC arthritis between January 2008 and May 2012 were reviewed retrospectively. The study included 13 female and 6 male patients, whose mean age was 62 years (range, 43 to 82 years). For clinical evaluation, we assessed the grip and pinch power, radial and volar abduction angle, thumb adduction (modified Kapandji index), including visual analogue scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiologic evaluation was performed using simple radiographs.

Results: The mean follow-up was 36 months (range, 19 to 73.7 months). Mean power improved from 18.3 to 27 kg for grip power, from 2.8 to 3.5 kg for tip pinch, and from 4.3 to 5.4 kg for power pinch. All patients showed decreased VAS from 7.2 to 1.7. Radial abduction improved from 71° preoperatively to 82° postoperatively. The modified Kapandji index showed improvement from 6 to 7.3, and mean DASH was improved from 41 to 17.8. The height of the space decreased from 10.8 to 7.1 mm. Only one case had a complication involving temporary sensory loss of the first dorsal web space, which resolved spontaneously.

Conclusions: The APL suspension ligamentoplasty for treatment of advanced first CMC arthritis yielded satisfactory functional results.

No MeSH data available.


Related in: MedlinePlus