Houston Methodist. Leading Medicine

Hand FAQ

Question:

I have terrible arthritis at the base of my left thumb. My surgeon has explained a new operation to help get my strength back. It's called a suspensionplasty. I understand all the ways this operation can help me but what can go wrong? Is there a downside to this procedure?

Answer:

The base of the thumb or carpometacarpal (CMC) joint is a frequent site of pain and deformity from arthritis. The goal of surgery is to relieve pain and restore strength and stability. There are many ways to accomplish this with surgery.

Suspensionplasty uses the abductor pollicis longus (APL) tendon to hold the main bone of the thumb (metacarpal) in place after removing the painful, arthritic bone (trapezium) at the base of the thumb.

The surgeon does this by drilling a tunnel through the metacarpal bones of the thumb and the index finger. The APL is threaded through these two tunnels and stitched in place.

The main problem after this operation is called subsidence. The thumb metacarpal can sink down into the space left by the missing bone. The "suspension" doesn't hold it in place as hoped. This may not cause problems at first but over time, pain and loss of function may require a second (revision) surgery.

A few patients who've had this operation report some weakness when opening jars or turning keys in locks. They also report mild discomfort or pain but most say they are much better than before the operation.

Osamu Soejima, MD, et al. Suspensionplasty with the Abductor Pollicis Longus Tendon for Osteoarthritis in the Carpometacarpal Joint of the Thumb. In The Journal of Hand Surgery. March 2006. Vol. 31A. No.3. Pp.425-428.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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