The Upper Hand: Chuck & Chris Talk Hand Surgery The LRTI in 2025
Jan 19, 2025
Chuck and Chris dive into the complexities of thumb arthritis and the gold standard care, LRTI. They compare their techniques and discuss innovations in hand surgery. Personal stories about travel, productivity, and amusing notes on winter antics add a light touch. The duo evaluates post-surgical pain management challenges and explores the latest approaches to trapezium excision. Insights from clinical trials pave the way for future surgical practices, making it an engaging blend of humor and expertise.
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Post-Trapeziectomy Pain
- A young patient experienced pain after a trapeziectomy with Tightrope fixation, not at the surgical site but at the second metacarpal button.
- The question arises if button removal would destabilize the construct and how to approach it surgically.
Mini Tightrope for CMC
- Use a mini Tightrope for CMC arthritis or instability, especially in revision cases, due to its simplicity.
- Ensure precise placement between the thumb and second metacarpal bases to avoid dorsal button placement and potential complications.
Tightrope Button Removal
- Remove the Tightrope button if it causes pain, as scar tissue formation often provides sufficient stability.
- Consider Tightrope as a revision option, not primary, due to potential technical complexities and button placement challenges.