Abstract des Autors

Dislocation of the trapezometacarpal joint is often considered a benign lesion and treated with simple cast or intermetacarpal pinning. This approach cannot stabilize this non-interlocked joint which confers major mobility to the thumb column. Surgical repair of the ligament is required for satisfactory anatomical restoration and to avoid chronic instability and post-trauma degeneration. A precise pre-operative work-up (physical examination, standard x-ray and sometimes arthroscopy) is needed to identify ligament tears as well as other associated pathologies. We prefer ligament reattachment using miniaturized suture anchors. For more chronic lesions or when ligament repair appears to be precarious, we propose early ligamentoplasy to reproduce the anatomy of the torn ligaments. Between 1990 and 1996, we have used this protocol for 22 trapezometacarpal dislocations. Outcome in terms of pain, stability, function, strength and mobility, was entirely successful in 19 thumbs. Sports activities can generally be resumed two months after surgery. Verf.-Referat