Haydarpasa Numune Training & Research Hospital, Department of Orthopaedics & Traumatology, Hand Surgery Clinic.
Akdeniz University Faculty of Medicine, Department of Orthopaedics & Traumatology.
Handchir Mikrochir Plast Chir. 2022 Feb;54(1):87-91. doi: 10.1055/a-1344-8846. Epub 2021 Feb 1.
Suture-button suspensionplasty has been popularized in the treatment of thumb carpometacarpal (CMC) arthritis in recent years. The surgical technique of this method was well defined previously. The most challenging and important part of this technique is the tensioning of the suture-button system to preserve first metacarpal height after trapeziectomy. In present study, we would like to present a technical trick about adjusting the tension while performing suspensionplasty using suture-button device in thumb CMC joint osteoarthritis. In the original technique, trapeziectomy is performed prior to fixation and tensioning of suture-button system. However, it is quite difficult to recreate the original trapezial space, since first metacarpal subsides after trapeziectomy. The trick in our technique is that trapezium remains in its anatomic position up to the end of the operation. Thus, we do not need to make effort to adjust the thumb ray height and use fluoroscopic imaging to ensure its position. In conclusion, we believe that our technique simplifies the most challenging part of the operation, shortens the operation time, preserves the original first ray height and diminishes the exposure of ionizing radiation as it reduces the need for fluoroscopy.
近年来，缝线纽扣悬吊成形术在治疗拇指腕掌（CMC）关节炎方面得到了广泛应用。该方法的手术技术以前已经得到了很好的定义。该技术最具挑战性和重要的部分是在切除大多角骨后，通过缝线纽扣系统的拉紧来保持第一掌骨的高度。在本研究中，我们想介绍一种在拇指 CMC 关节骨关节炎中使用缝线纽扣装置进行悬吊成形术时调整张力的技术技巧。在原始技术中，在固定和拉紧缝线纽扣系统之前进行大多角骨切除术。然而，由于大多角骨切除后第一掌骨下沉，因此要重新创建原始大多角骨空间非常困难。我们技术的诀窍是，直到手术结束，大多角骨仍保持在解剖位置。因此，我们不需要费力地调整拇指射线的高度，并使用透视成像来确保其位置。总之，我们相信我们的技术简化了手术中最具挑战性的部分，缩短了手术时间，保持了第一射线的原始高度，并减少了电离辐射的暴露，因为它减少了透视的需要。
