Trapeziectomy in the treatment of rhizarthrosis : Surgical technique and functional evaluation

Rhizarthrosis is a common disease, most frequently affecting women after the menopause. It corresponds to damage to the trapeziometacarpal joint, which is unstable and subject to very high forces, which explains the frequency of degenerative damage. Clinical diagnosis is easy when pain is felt at the base of the thumb. X-rays confirm the involvement of the trapeziometacarpal joint, and sometimes its extension to adjacent joints. Progression is characterized by a reduction in pain, at the cost of a Z- or H-shaped deformity of the thumb column, which can be functionally disabling (1). Treatment is based on long-term nocturnal splinting, analgesics, NSAIDs and even local injections of corticoids or hyaluronic acid, whose effectiveness needs to be better evaluated. In the event of failure, surgery is performed: trapezectomy or, more rarely, prosthesis (2-3).