Time reduction with a mini power saw blade in first carpometacarpal Ensemble arthroplasty: a case report.

Abstract

Background: Shaping the trapezium and metacarpal base during first carpometacarpal (CMC) Ensemble arthroplasty traditionally relies on manual rasping. This is time-consuming and poses the risk of iatrogenic nerve injury due to repeated rasping near the dorsal and volar branches of the dorsal radial sensory nerve. This case report presents a novel modification to the surgical technique by integrating a mini power saw to streamline joint space preparation.

Case presentation: A 56-year-old Caucasian female patient presented with advanced first carpometacarpal osteoarthritis and chronic pain. She underwent multiple rounds of corticosteroid injections into the first carpometacarpal joint that provided only short-term relief. She expressed her desire for long-term relief and underwent Ensemble arthroplasty at the first carpometacarpal with this modification to the technique. Intraoperative fluoroscopy confirmed optimal implant positioning. The patient began occupational therapy 2 weeks post-surgery, attending sessions two to three times per week.

Conclusion: This innovative approach reduced operative time by 20 minutes compared to traditional rasping, with postoperative outcomes comparable to those of the standard technique. This report highlights a potential advancement in surgical efficiency and safety.