Evolution of Metacarpal Subsidence following Trapeziectomy Article Swipe

MAKE IMPACT

Abigail Meyers , Jillian P. Krebs , Antonio Rampazzo , Bahar Bassiri Gharb · YOU? · · 2021 · Open Access · · DOI: https://doi.org/10.1097/01.gox.0000799588.01612.a5

PURPOSE: The aim of this study was to investigate the temporal evolution of subsidence following trapeziectomy and its correlation with clinical outcomes. METHODS: An IRB-approved retrospective review of patients who underwent trapeziectomy for osteoarthritis of the first carpometacarpal joint was conducted (2003–2019). Patients with osteoarthritis of the metacarpophalangeal joint of the thumb, or wrist were excluded. Demographic information and clinical outcome data were collected. Connolly-Rath scores were determined. Subsidence was measured as the ratio of the difference between the trapezial space (TS = distance from base of thumb metacarpal to scaphoid) preoperatively and postoperatively over the TS preoperatively, and classified as severe (≥70%), or mild–moderate (<70%). The average rate of increase in subsidence was calculated. Student t-tests were used to compare continuous variables. Pain scores were compared using a Mann-Whitney U test. A Chi-square test was used to assess the difference in proportions of Conolly-Rath scores, and 95% confidence intervals were calculated for the proportion of good outcomes. Pearson's correlation test was used to assess the relationships between subsidence and outcomes. RESULTS: One hundred forty-one trapeziectomies were included. Average age at surgery was 60 ± 11 years; 84% of patients were women. An average of 2.34 ± 1.6 x-rays per hand were analyzed up to 12 years postoperatively. Median subsidence was 70% (56%–81%). The subsidence increased by 41.7 ± 98.6% per week, before 16 weeks and 0.9 ± 4.0% per week, thereafter. After 16 weeks, the median pain score was 3 (0–5) (n = 14) in the severe group and 1 (0–3) (n = 28) in the mild-moderate group (P = 0.25). There was no correlation between subsidence and pain (ρ = −0.05, P = 0.74). Average key, tripod, and index tip pinch strengths were 10.7 ± 3.8, 12.0 ± 1.4, and 7.4 ± 1.9 lbs in the severe group, and 9.2 ± 3, 9.5 ± 1.9, and 7.3 ±2.5 lbs in the mild–moderate group. The differences in each parameter were not significantlydifferent between groups (P = 0.39, 0.08, and 0.95). There was no significant correlation between subsidence and key (ρ = −0.07, P = 0.81), tripod (ρ = 0.43, P = 0.30), or index tip pinch strength (ρ = −0.33, P = 0.34). Average grip strength was 55.8 ± 19.0 lbs in the severe group (n = 9) and 42.8 ± 23.2 lbs in the mild–moderate group (n = 8) (P = 0.21). There was no correlation between subsidence and grip strength (ρ = −0.06, P = 0.81). Average radial abduction was 46 ± 15 degrees in the severe group (n = 10) and 45 ± 20 degrees in the mild–moderate group (n = 5) (P = 0.95). Palmar abduction showed no difference between patients with severe (46 ± 9 degrees, n = 8) and moderate subsidence (47 ± 14 degree, n = 5) (P = 0.90). There was no correlation between subsidence and radial (ρ = −0.03, P = 0.91) or palmar (ρ = −0.17, P = 0.58) abduction. The proportion of good outcomes after 16 weeks (Connolly-Rath scores) in the severe group was 33.3% (n = 15) (95% CI 9.5–57.2%) and 57.6% (n = 33) (95% CI 40.7–74.4%) in the mild–moderate group, with no significant difference in frequency of good, compared with fair and poor, outcomes among the groups (P = 0.12). CONCLUSIONS: Subsidence occurred in all patients after trapeziectomy, stabilizing 16 weeks after cast removal. There were no differences in postoperative pain, pinch strength, grip strength, radial abduction, palmar abduction, or Connolly-Rath scores between patients with severe or mild-moderate subsidence. Subsidence did not significantly correlate with clinical outcome measures.

Type

article

Language

en

Landing Page

https://doi.org/10.1097/01.gox.0000799588.01612.a5

OA Status

gold

Cited By

1

Related Works

10

OpenAlex ID

https://openalex.org/W4200487244

Raw OpenAlex JSON

OpenAlex ID

https://openalex.org/W4200487244

Canonical identifier for this work in OpenAlex

DOI

https://doi.org/10.1097/01.gox.0000799588.01612.a5

Digital Object Identifier

Title

Evolution of Metacarpal Subsidence following Trapeziectomy

Work title

Type

article

OpenAlex work type

Language

en

Primary language

Publication year

2021

Year of publication

Publication date

2021-10-01

Full publication date if available

Authors

Abigail Meyers, Jillian P. Krebs, Antonio Rampazzo, Bahar Bassiri Gharb

List of authors in order

Landing page

https://doi.org/10.1097/01.gox.0000799588.01612.a5

Publisher landing page

Open access

Yes

Whether a free full text is available

OA status

gold

Open access status per OpenAlex

OA URL

https://doi.org/10.1097/01.gox.0000799588.01612.a5

Direct OA link when available

Concepts

Medicine, Carpometacarpal joint, Osteoarthritis, Thumb, Metacarpophalangeal joint, Surgery, Confidence interval, Wrist, Mann–Whitney U test, Subsidence, Orthodontics, Internal medicine, Structural basin, Biology, Pathology, Alternative medicine, Paleontology

Top concepts (fields/topics) attached by OpenAlex

Cited by

1

Total citation count in OpenAlex

Citations by year (recent)

2025: 1

Per-year citation counts (last 5 years)

Related works (count)

10

Other works algorithmically related by OpenAlex

Full payload