Trapeziectomy With Hemi-Abductor Pollicis Longus and SutureTape InternalBrace: A Technical Note and Case Series.

BACKGROUND

Trapeziometacarpal osteoarthritis (rhizarthrosis) is a common cause of thumb pain and functional impairment. Although trapeziectomy remains the gold standard for pain relief, postoperative first metacarpal migration and scaphometacarpal impingement have led to the development of stabilization techniques. These procedures, however, are often technically demanding and lack consensus.

METHODS

We describe a simplified suspensionplasty technique combining trapeziectomy with a hemi-abductor pollicis longus tendon and SutureTape InternalBrace reinforcement. A single-center retrospective study included 6 patients with Dell stage II-IV rhizarthrosis treated between January 2018 and March 2025 by a single experienced level IV surgeon (Tang and Giddins classification). Outcomes included pain (visual analog scale), function using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire, key and grip pinch strength, Kapandji opposition score, and radiographic trapezial index. Pre- and postoperative values were compared.

RESULTS

At a mean follow-up of 36 months, pain significantly decreased from 8.0 ± 0.89 to 1.83 ± 1.47. The QuickDASH score improved from 67.0 ± 15.08 to 17.83 ± 8.80. Key pinch strength increased from 4.07 ± 1.86 to 5.02 ± 2.37 kg, and grip strength increased from 18.0 ± 5.93 to 23.67 ± 6.38 kg. The Kapandji score improved from 7.67 ± 0.82 to 9.67 ± 0.52. The trapezial index decreased from 0.407 ± 0.053 to 0.311 ± 0.078. No major subluxations were observed, and no revision procedures were required.

CONCLUSIONS

This simplified InternalBrace-reinforced suspensionplasty seems safe, reproducible, and effective for pain relief and functional improvement in trapeziometacarpal osteoarthritis. Larger prospective studies are needed to confirm long-term outcomes.