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Trapezial Osteotomy for the Treatment of Trapezial Dysplasia

El-Mahy, Mohammed M. MD

doi: 10.1097/SAP.0b013e3182a1ad9d
Hand Surgery

Dysplastic trapezium is a condition that is characterized by an exaggerated slant (slope) of the distal articular surface of the trapezium in relation to the axis of the second metacarpal. Usually, it becomes evident in the late teens and early 20s with proximolateral subluxation of the base of the first metacarpal and is associated with pain at the base of the thumb. It is more common in the dominant hand of women, but can affect both hands and either sex. The condition can be progressively painful and incapacitating, and those patients will require early support with medical treatment. Surgical management is indicated in persistent cases. In this study, we aimed at correcting theabnormal trapezial tilt in nonarthritic trapeziometacarpal joints by a dorsoradial open wedge osteotomy and bone graft, restoring the normal biomechanics around the joint, abolishing the abnormal loads sustained by the ligaments, and aiming to prevent the development of arthritic changes.

From the Ain Shams University, Cairo, Egypt.

Received April 24, 2013, and accepted for publication, after revision, June 21, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Mohammed M. El-Mahy, MD, 87 Al Maqrizi St, Heliopolis, Cairo, Egypt. E-mail:

© 2013 by Lippincott Williams & Wilkins