J Wrist Surg 2015; 04 - A015
DOI: 10.1055/s-0035-1567907

Partial- and Full-Thickness Tears of Flexor Carpi Radialis Complicating Excision Arthroplasty and Suspensionplasty of the Trapezium to Treat Trapeziometacarpal Joint Arthritis

Jeff Ecker 1, 2
  • 1Western Orthopaedic Clinic, Perth, Western Australia
  • 2Hand and Upper Limb Centre, Perth, Western Australia

Over 6 years (2007–2013), 119 excision arthroplasties of the trapezium were performed to treat trapeziometacarpal joint arthritis. The trapezium was completely excised and a distal slip of abductor pollicis longus (APL) tendon was used to create a suspensionplasty. Twenty-three cases developed pain, which was attributed to the flexor carpi radialis (FCR) tendon. Twelve of the 23 cases had full-thickness FCR tears, and 11 of the 23 cases had partial-thickness tears.

Of the 12 full-thickness tears, five had severe pain that resolved when the FCR was reconstructed with a palmaris longus (PL) tendon graft. In seven patients the pain spontaneously resolved.

Of the partial-thickness tears of the FCR, one had persistent pain that resolved with tendon grafting.

One case with a full-thickness tear of the FCR developed radial midcarpal joint instability that resolved when repaired with a tendon graft.