Long term results of trapeziectomy alone vs with FCR suspension v1.6
Research type
Research Study
Full title
Long term results of a randomised controlled trial of simple trapeziectomy versus trapeziectomy and Flexor Carpi Radialis (FCR) suspension.
IRAS ID
133938
Contact name
Adrian Brennan
Contact email
Sponsor organisation
Gloucestershire Research Support Service
Duration of Study in the UK
0 years, 3 months, 3 days
Research summary
This is a long term follow-up of a randomised controlled trial conduced from 2002 to 2003 in Cheltenham General Hospital (CGH) and published in 2007 by Mr Field in the Journal of Hand Surgery.
The carpometacarpal joint of the thumb is the second most common site of osteoarthritis in humans and trapeziectomy, the removal of the trapezium bone from the hand, is perhaps the commonest operative treatment.1 The operation can also involve suspension of the metacarpal of the thumb using a part of the tendon of Flexor Carpi Radialis (FCR), which theoretically stops the metacarpal descending into the space left by the excised trapezium thereby possibly reducing pain and improving function. 10 years ago there were few studies to show whether or not this FCR suspension was of benefit to the patient. Our initial study showed that at 12 month follow up the FCR suspension group had a greater gap on Xray, but there was no significant difference between the two groups in terms of patient satisfaction and thumb function and strength.
There are no studies comparing the long term outcomes of the two procedures. We do not know if the increased gap seen in FCR suspension is maintained long term. Furthermore, while an increased gap at 12 months does not to correlate to improved thumb function or pain, we do not know if this remains the case at 10 years and beyond.
We propose to recall the original participants in the study to subjectively review their satisfaction and objectively review their function at the 10 year point. Furthermore we will assess the scaphometacarpal gap with xray. This will involve the original participants completing a questionnaire, being reviewed by an independent hand physiotherapist and having two plain film radiographs (x-rays) of the hand.
REC name
London - Riverside Research Ethics Committee
REC reference
17/LO/1259
Date of REC Opinion
31 Aug 2017
REC opinion
Favourable Opinion