Short-Term Results of the Hammock Method Combined with the Mini TightRope® for Thumb Carpometacarpal Arthrosis.

Abstract

Background: Suspension arthroplasty using the abductor pollicis longus (APL) tendon for advanced thumb carpometacarpal (CMC) arthrosis is known as the hammock method. We retrospectively investigated the short-term results of a previous attempt to use this method combined with the Mini TightRope^® to improve CMC joint stability. Methods: We included 22 hands of 19 patients (4 men and 15 women; mean age: 61.7 years) with primary advanced thumb CMC arthrosis who underwent this procedure during the past 4 years. All patients had Eaton stages II-IV thumb CMC arthritis. The Mini TightRope^® was inserted before APL tendon fixation to the metacarpal bone. After a 2-week immobilisation, the patients were permitted unrestricted hand usage. We assessed the grip and pinch strength; radial and volar abduction angles; the quick disabilities of the arm, shoulder and hand (quick DASH), hand 20 and Kapandji scores; trapezial height before surgery and at the final follow-up; postoperative complications and operative time. Results: The mean follow-up was 24.2 months, and the mean operative time was 58.1 minutes. The grip, tip pinch and side pinch strengths increased postoperatively. Additionally, the radial and volar abduction angles improved. The Kapandji, quick DASH and hand 20 scores showed improvements. The mean trapezial height was 8.4 mm preoperatively and 6.4 mm at the final follow-up. Postoperative complications included superficial radial neuropathy (n = 3), thumb flexor tendinitis (n = 2) and flexor carpi radialis (FCR) tendinitis (n = 3). Conclusions: The hammock method combined with the Mini TightRope^® shows good short-term results. Level of Evidence: Level IV (Therapeutic).