<< Back to the abstract archive
Evolution of Metacarpal Subsidence Following Trapeziectomy Does Not Correlate with Pain
Abigail Meyers, BS; Jillian Krebs, BS; Arvin Smith, BS; Antonio Rampazzo, MD, PhD; Bahar Bassiri Gharb, MD, PhD
Cleveland Clinic Department of Plastic Surgery
2021-01-31
Presenter: Abigail Meyers
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. A majority of the study design, data collection, analysis, and writing in preparation of the abstract was carried out by the first author.
Director Name: Bahar Bassiri Gharb
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Purpose
This study investigated the temporal evolution of subsidence following trapeziectomy and its correlation with pain.
Methods
An IRB-approved retrospective review of patients who underwent trapeziectomy was conducted. Patients with osteoarthritis of the metacarpophalangeal joint of the thumb or wrist were excluded. Demographics and pain scores were recorded. Subsidence was measured as the ratio of the difference between the trapezial space (TS=distance from base of metacarpal to scaphoid) preoperatively and postoperatively over the TS preoperatively and classified as severe (≥70%) or moderate-mild (<70%). Average rate of subsidence increase was calculated. Pain scores were compared using Mann-Whitney U tests. Pearson's correlation was used to assess the relationship between subsidence and pain.
Results
Ultimately 125 patients (141 trapeziectomies) were included. Average age at surgery was 60±11 years and 84% were female. An average of 2.3±1.6 x-rays per hand were analyzed. Median subsidence was 70% (56-81%). The subsidence increased by 41.7±98.6% per week, before 16 weeks and 0.9±4.0% per week thereafter. Average subsidence was 57.8±18.6% before 16 weeks and 69.7±17.1% afterwards.
After 16 weeks, pain scores were available for 23 patients with severe subsidence and 12 with moderate-mild subsidence. The median pain scores were 1 (0-5) and 0 (0-2) for the respective groups (p=0.24). There was no correlation between subsidence and pain (ρ=0.053, p=0.76).
Conclusions
Subsidence occurs in all patients, stabilizing 16 weeks after cast removal. The degree of subsidence does not correlate with postoperative pain.
