Prospective RCT of 153 thumbs randomized to simple trapeziectomy, trapeziectomy with palmaris longus interposition, or trapeziectomy with FCR ligament reconstruction and tendon interposition (LRTI), asking whether the added soft tissue procedures improve outcomes over trapezial excision alone at a minimum of 5 years (median 6 years, range 5–18 years).
When a patient presents with Eaton-Littler grade 2–4 trapeziometacarpal arthritis refractory to nonoperative treatment, simple trapeziectomy (with K-wire stabilization and 6-week spica) delivers equivalent long-term pain relief and function as the more complex LRTI — choose the simpler operation and spare the patient 20 extra minutes of tourniquet time and a forearm harvest scar without sacrificing any outcome.
Prospective RCT of 153 thumbs randomized to simple trapeziectomy, trapeziectomy with palmaris longus interposition, or trapeziectomy with FCR ligament reconstruction and tendon interposition (LRTI), asking whether the added soft tissue procedures improve outcomes over trapezial excision alone at a minimum of 5 years (median 6 years, range 5–18 years).
When a patient presents with Eaton-Littler grade 2–4 trapeziometacarpal arthritis refractory to nonoperative treatment, simple trapeziectomy (with K-wire stabilization and 6-week spica) delivers equivalent long-term pain relief and function as the more complex LRTI — choose the simpler operation and spare the patient 20 extra minutes of tourniquet time and a forearm harvest scar without sacrificing any outcome.