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A D V E R T I S E M E N T
A D V E R T I S E M E N T
This was followed in 1986 by Burton et. al., who wove part of the FCR tendon through a hole in the base of the first metacarpal, folded it under to resurface the base, and rolled the remainder to fill the space of the excised trapezium.
A D V E R T I S E M E N T
Unfortunately, a version of this operation designed by Dr. Mack Clayton who excised the base of the first metacarpal and flattened the trapezium rapidly failed because of erosion of the "anchovy" of tendon into the soft cancellous bone of the base of the metacarpal. This allowed collapse and contact of the metacarpal with the trapezium, causing great pain.
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A D V E R T I S E M E N T
The current trend in repair of severe metacarpotrapezial osteoarthritis involves trapezial excision, autologous tendon or fascial ligament spacer interposition and woven tendon stabilization. The LRTI (ligamentous reconstruction and tendon interposition) by Burton and Pellegrini is perhaps the most famous and often used for metacarpal trapezial joint osteoarthritis.
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