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Basal Thumb Arthritis / Trapezectomy

As I discussed in the small joint section, trapezectomy has now become more of a popularised procedure for basal thumb OA. However it is not as simple as this.

In younger patients with early changes, arthroscopy and debridement with or without an interposition can be performed. The other option is a metacarpal osteotomy, although less popular.

In some patients the development of a Beak Ligament (Anterior Oblique Ligament) rupture can be the cause of pain and early OA. Here a ligament reconstruction is the ideal treatment.

Generally, however, I would recommend a trapezectomy and ligament suspension in the younger patients, and those with subluxation of the joint, while performing trapezectomy alone in the elderly patients with simple OA.


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