Thumb CMC Joint Suspensionplasty Surgery

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Evolution of Thumb CMC Joint Suspensionplasty Surgery

Suspensionplasty refers to the step that some surgeons perform after removing the trapezium bone to suspend the metacarpal base some distance away from the scaphoid bone that now sits underneath it. This step is aimed at preventing the metacarpal base from settling over time, possibly leading to some recurrence of pain as the space narrows. The historic way of doing this involved drilling metal pins ( K-wires) into the neighboring second metacarpal bone during the healing process so that the scar tissue stabilizes the first metacarpal base in a spaced-out position; these pins are removed at four to six weeks after surgery. The pins can get infected and are sometimes painful. Another common way to suspend the first metacarpal base is to weave a tendon, harvested from nearby in the wrist, through the base of the bone and secure it back to itself. This technique requires borrowing a tendon from nearby, and it may be prone to some amount of settling over time as the body partially resorbs the tendon. Because of these concerns, surgeons looked for an implant or device that could be placed through the metacarpal base to stabilize it. The ideal implant could be left in place and would not degrade over time.

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