ARTICLE IN PRESS

THE JOURNAL OF HAND SURGERY VOL. 31B No. S1 JUNE 200684

remained in one wrist. There were 25 excellent, twogood, one fair and one poor results.Conclusions: This reconstruction technique representedreal anatomical reattachment of the TFCC to the ulnarfovea, which induced excellent DRUJ stability andclinical results.

10.1016/j.jhsb.2006.03.056

17.8 TRAPEZIECTOMY – TO SUSPEND OR NOT TO

SUSPEND A RANDOMIZED PROSPECTIVE SINGLE

BLIND TRIAL OF SIMPLE TRAPEZIECTOMY VER-

SUS TRAPEZIECTOMY PLUS FCR SUSPENSION

J. Field1 and D. Buchanan21Gloucestershire Hospitals NHS Trust, Cheltenham,

Gloucestershire, UK;2City Hospital, Nottingham, UK

Introduction: Osteoarthritis of the thumb CMCJ is verycommon. There are numerous operations for thecondition, but perhaps the commonest is trapeziectomy,which can be supplemented with a suspension proceduregenerally using FCR.This is a prospective randomized single blind controlledstudy comparing simple trapeziectomy with trapeziect-omy and FCR suspension.Materials and methods: Sixty-five patients with eitherEaton and Glickel grade III or IV arthritis of the CMCJof their thumbs were randomized into either having atraditional trapeziectomy (with no wiring), or a trape-ziectomy with FCR suspension. The surgery wasperformed by one surgeon. All patients were assessedpre- and postoperatively (at 3,6 and 12 months) by anindependent physiotherapist measuring pain on visualanalogue scores doing various activities, range ofmovement and grip and pinch strength. X-rays weretaken at the same intervals. Complication rate washigher in the FCR group.Results: Patient satisfaction from both operations wassimilar. There was a slight increase in range of move-ment in the trapeziectomy alone group. There was nosignificant difference between visual analogue scores forpain. Measurement of the gap left by the trapeziectomywas less when trapeziectomy alone was performed.Discussion: In conclusion this study does show that theLRTI has more complications than the simple trape-ziectomy. It does maintain the height of the arthroplastyspace after trapeziectomy, but it also shows thatmaintaining that space is of no consequence.

10.1016/j.jhsb.2006.03.057

17.9 THE FLEXOR CARPI RADIALIS TENDON AND

SCAPHOTRAPEZIAL INTEROSSEOUS LIGAMENT

AS SECONDARY STABILIZERS OF SCAPHOID MO-

TION

S. Moran, K. Zhao, L. Ronald and K. AnMayo Clinic, Rochester, USA

Purpose: The role of the flexor carpi radialis (FCR) andscaphotrapezial interosseous ligament (STIL) as sec-ondary stabilizers of the scaphoid has not been fullyexamined. This study investigates the effects of the FCRand STIL division on scaphoid and lunate motion in acadaver wrist model.Methods: Eight fresh frozen cadaver wrist forearms wereselected after exclusion of significant degenerativechanges and scapholunate injury. The radius and ulnawere transfixed with Steinmann pins in neutral forearmrotation and the fingers were disarticulated at themetacarpophalangeal joint. A 250 g load was appliedto the ECRL, ECRB, APL, ECU, FCR, and FCU tosimulate normal compression across the wrist due tomuscle tone. A magnetic tracking device (3SpaceFastrak System) and accompanying software was usedto record the kinematics of the scaphoid, lunate, and the3rd metacarpal shaft. The global coordinate system wasconstructed on the radius prior to data collection.Kinematic data was collected during flexion, extension,radial and ulnar deviation. Specimens were tested underthe following conditions: (1) ligaments intact, (2) STILcut, (3) FCR cut, (4) FCR unloaded, (5) STIL CUT andFCR unloaded.Results: With STIL division there was a small butappreciable increase in scaphoid extension and radialdeviation throughout the flexion and extension arc andwith radial and ulnar deviation. With the STIL cut andFCR unloaded the scaphoid assumed an average of 31 ofextension and 11 of radial deviation in comparison tothe intact specimens.Conclusion: The results of this study suggest that theSTIL helps maintain scaphoid flexion. Unloading orremoving the FCR tendon from its insertion orattachment at the scaphoid moves the scaphoid intoan extension position. This suggests that the flexionmoment exerted by the FCR, both through its attach-ment to the scaphoid and through its wrapping aroundthe scaphoid, may be important for maintainingscaphoid position.

10.1016/j.jhsb.2006.03.058