Suture Button Suspension following Trapeziectomy in a Cadaver Model

Abstract

Background

The safety and the effects of different trajectories on thumb motion of suture-button suspensionplasty post-trapeziectomy are not known.

Method

In a cadaveric model, thumb range of motion, trapeziectomy space height, and distance between the device and nerve to the first dorsal interosseous muscle (first DI) were measured for proximal and distal trajectory groups. Proximal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory less than 60° from the horizontal; distal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory of greater than 60° from the horizontal (Fig. 1).

Fig. 1

The red line represents the “horizontal” line. a Guidewire placed in a proximal trajectory at an angle of 17°. b Guidewire placed in a distal trajectory at an angle of 60°

Results

There were no significant differences in range of motion and trapeziectomy space height between both groups. The device was significantly further away from the nerve to the first DI in the proximal trajectory group compared to the distal trajectory group, but was still safely away from the nerve in both groups (greater than 1 cm). Conclusions These results suggest that the device placement in either a proximal or distal location on the second metacarpal will yield similar results regarding safety and thumb range of motion.