Article ID: JNMS.2019_86-507
Background: We compared the clinical results between a newly modified abductor pollicis longus (APL) suspension arthroplasty with trapeziectomy procedure (modified Thompson procedure) and the original APL suspension arthroplasty with trapeziectomy procedure (original Thompson procedure) for treatment of advanced osteoarthritis of the thumb carpometacarpal (CMC) joint and assessed the efficacy of the modified Thompson procedure for thumb CMC osteoarthritis.
Methods: Ten hands of 10 patients (Group 1) were treated by the original Thompson procedure. Twenty hands of 16 patients (Group 2) were treated by the modified Thompson procedure, in which the bone tunnel positions were rearranged for passage of the transferred APL more dorsoradially than Group 1.
Results: The thumb palmar and radial abduction angles; pinch power; grip strength; Quick Disability of Arm, Shoulder, and Hand questionnaire (Quick DASH) score; and visual analog scale (VAS) score were significantly different before and after surgery. There were no statistically significant differences in the thumb palmar abduction angle, pinch power, grip strength, Quick DASH score, or VAS score between Groups 1 and 2. However, patients in Group 2 had a significantly better range of motion of radial abduction in the thumb than those in Group 1.
Conclusions: The modified Thompson procedure is a simple and effective technique that can improve the thumb radial abduction angle compared with the original technique in patients with advanced thumb CMC osteoarthritis. Additionally, this new technique is as useful as the original procedure in early restoring thumb function and relieving pain.
