Mountain West 2019 Abstract Supplement
PURPOSE: T-plate fixation is a popular method for trapeziometacarpal arthrodesis (TMA) in the osteoarthritic patient.1–6 Previous studies report 8–18% rate symptomatic nonunion, 26% rate radiographic nonunion. The addition of an oblique lag screw to T-plate fixation may compress the arthrodesis site and decrease nonunion rate.
METHODS: A retrospective review of all TMA for osteoarthritis by a single surgeon between 2010- 2018 was completed. The technique was identical in all surgical cases, utilizing an oblique lag screw across the arthrodesis site from the metacarpal to the trapezium. Postoperative nonunion rate and time to clinical healing and radiographic union were reviewed.
RESULTS: A total of 22 TMA were performed on 17 patients using the above technique. The average age was 53, 71% female, 53% involving the dominant hand. All patients preoperatively reported constant pain refractory to conservative management. Mean preoperative Eaton classification was 2.74 (± 0.73). Mean time to clinical healing was 34 days (± 12 days), and mean time to radiographic union was 55 days (± 23 days). Mean follow up was 9 months, and no patients were found to have symptomatic or radiographic nonunion. Hardware removal was required bilaterally in one patient after complete healing.
CONCLUSIONS: The addition of oblique lag screw to T-plate fixation is a novel technique in TMA. In this study, no patients were found to have symptomatic or radiographic nonunion, which is lower than other published rates utilizing other techniques.