Suspensionplasty is an elective surgical procedure designed to relieve pain and restore function to the thumb, typically addressing arthritis at the base of the thumb. This surgery reconstructs the arthritic joint, often involving the removal of all or part of the trapezium bone at the base of the thumb's carpometacarpal (CMC) joint.
Here's a more detailed breakdown:
Understanding Suspensionplasty
Suspensionplasty aims to eliminate the bone-on-bone contact in the arthritic CMC joint that causes pain. It achieves this through a combination of joint cleaning, bone removal (typically the trapezium), and reconstruction.
The Surgical Process
- Incision: A small incision is made at the base of the thumb.
- Trapezium Removal: Some or all of the trapezium bone, which articulates with the base of the thumb, is removed. The trapezium is a small bone in the wrist that directly connects to the thumb's metacarpal bone. Removing it eliminates a primary source of arthritic pain.
- Reconstruction: After the trapezium is removed, a tendon graft, often taken from one of the patient's own tendons (such as the flexor carpi radialis or a portion of the abductor pollicis longus), is used to fill the space left behind. This creates a "sling" or "suspension" that supports the thumb's metacarpal bone and prevents it from collapsing into the space where the trapezium used to be. The tendon graft interposes between the scaphoid and the base of the first metacarpal.
- Stabilization: The tendon graft is secured to nearby ligaments or bone to provide stability to the thumb.
Goals of Suspensionplasty
- Pain Relief: Reducing or eliminating pain in the thumb, especially during gripping or pinching activities.
- Improved Function: Restoring range of motion, strength, and dexterity to the thumb, enabling better use of the hand.
- Increased Stability: Providing support to the thumb joint to prevent further deterioration and instability.
Who is a Good Candidate?
Patients with basal joint arthritis (arthritis at the base of the thumb) who experience significant pain and functional limitations despite conservative treatments like splints, medications, and injections are often considered good candidates for suspensionplasty.
Recovery
Recovery after suspensionplasty typically involves a period of immobilization in a cast or splint, followed by a gradual rehabilitation program to restore strength and range of motion. The full recovery process can take several months.
