Lorenzana Daniel J, Abar Bijan, DiPrinzio Eliseo V, Vail Elijah, Welch Jessica M, Klifto Christopher S, Ruch David S, Richard Marc J, Gall Ken, Pidgeon Tyler S
Duke University Medical Center, Durham, NC, USA.
Department of Mechanical Engineering and Materials Science, Duke University, Durham, NC, USA.
Hand (N Y). 2025 Jul 11:15589447251350175. doi: 10.1177/15589447251350175.
Trapeziectomy with suture button suspensionplasty (SBS) is a common treatment for thumb carpometacarpal (CMC) osteoarthritis. This study aimed to evaluate the effect of bone tunnel configuration and suture count on the construct stability.
Twelve matched specimens underwent trapeziectomy and randomization to either a 2-strand 1-tunnel (single SBS) or divergent 4-strand 2-tunnel suture button (crossed dual SBS) construct. Mechanical stiffness was measured using material testing machine with a semiconstrained axial load over 5-mm displacement. Trapezial space was measured under no load and in a light and heavy physiologic pinch grip models. Subsequently, specimens were randomized to undergo single SBS or divergent 2-strand 2-tunnel suture (crossed suture) constructs, and loaded pinch testing was performed. Primary outcomes were analyzed using matched-pair -tests.
The crossed dual SBS construct showed significantly higher stiffness compared to the single SBS construct in elastic deformation (19.9 vs 15.5 N/mm, = .010) and maintained trapezial height better in both light (82% vs 71%, = .021) and heavy (73% vs 46%, p = .004) pinch grips. The crossed suture technique also preserved trapezial height better than the single SBS construct in light (79% vs 64%, = 0.021) and heavy (60% vs 44%, = 0.039) pinch grips.
In the immediate postoperative period, a crossed dual SBS construct was stiffer to axial load and more stable in pinch grip compared to a single SBS construct. The novel crossed suture construct better preserved trapezial height then the singe SBS, suggesting that the crossed configuration may be more relevant than suture count in postoperative stability.
带缝线纽扣悬吊成形术（SBS）的大多角骨切除术是治疗拇指腕掌关节（CMC）骨关节炎的常用方法。本研究旨在评估骨隧道构型和缝线数量对结构稳定性的影响。
12个匹配的标本接受大多角骨切除术，并随机分为双股单隧道（单SBS）或发散四股双隧道缝线纽扣（交叉双SBS）结构。使用材料试验机在5毫米位移上施加半约束轴向载荷来测量机械刚度。在无载荷以及轻、重生理性捏握模型下测量大多角骨间隙。随后，将标本随机分为接受单SBS或发散双股双隧道缝线（交叉缝线）结构，并进行加载捏握测试。使用配对检验分析主要结果。
在弹性变形方面，交叉双SBS结构相比单SBS结构显示出显著更高的刚度（19.9对15.5N/mm，P = 0.010），并且在轻捏握（82%对71%，P = 0.021）和重捏握（73%对46%，P = 0.004）时均能更好地保持大多角骨高度。交叉缝线技术在轻捏握（79%对64%，P = 0.021）和重捏握（60%对44%，P = 0.039）时也比单SBS结构更好地保留了大多角骨高度。
在术后即刻，与单SBS结构相比，交叉双SBS结构对轴向载荷更具刚性，在捏握时更稳定。新型交叉缝线结构比单SBS能更好地保留大多角骨高度，这表明交叉构型在术后稳定性方面可能比缝线数量更重要。
