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HS9: INTERFERENCE SCREW FIXATION IN TRAPEZIOMETACARPAL ARTHROPLASTY



Abstract

A new technique of trapeziometacarpal suspension arthroplasty is described.

Suspension arthroplasty as a treatment for trape-ziometacarpal arthritis has been studied extensively in the literature, but only using relatively weak forms of tendon-bone fixation. Interference screw fixation for tendon grafts has been proven in other areas of the body such as the knee and shoulder. Our technique involves trapeziectomy and suspension arthroplasty using one half of the flexor carpi radialis tendon, left attached distally. A short segment (approximately 2 cm) is harvested and passed through a 4 mm drill hole in the proximal thumb metacarpal. This is accurately positioned using an initial K-wire and then a cannulated drill. Fixation is achieved with a 4 mm Bio-tenodesis screw (Arthrex) and enhanced using a 4/0 Fibrewire (Arthrex) Krackow suture weave. Due to the strength of fixation, no supplemental fixation is required and immobilisation is only used in the initial postoperative period. There is no need for additional support in the form of tendon interposition.

Although these are preliminary results, this technique shows promise for an improvement in outcome for the surgical treatment of thumb carpometacarpal arthritis, compared to current methods

The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au

Declaration of interest: a