First CMC jointEntire Flexor Carpi Radialis Tendon Harvest for Thumb Carpometacarpal Arthroplasty Alters Wrist Kinetics
Section snippets
Methods
From 2002 to 2004, 39 patients with osteoarthritis who had unilateral LRTI with the entire width of the FCR tendon were studied prospectively. The nonsurgically treated extremity served as the control limb. Institutional review board approval was obtained before proceeding with the study. All patients were assessed before and after surgery for Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score, grip, key pinch, tip pinch, and tripod pinch. Postoperative data were obtained
Results
The average age of the study population was 57 years (range, 43–81 years). There were 9 men and 30 women. There were no major complications. Superficial radial nerve neuritis symptoms were encountered in about 20% of patients within the first 3 months after surgery; however, 3 patients had persistent sensory complaints along the superficial radial nerve distribution at the 2-year follow-up evaluation.
Before surgery the affected extremity was 14% weaker than the control extremity in grip
Discussion
Relative strengths of the flexor and extensor tendons are well established in the tendon transfer literature. With the FCR muscle as the reference it is well known that the relative strengths of the FCU, flexor pollicis longus, each of the digital flexors, extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, and each of the digital extensors are 2, 1, 0.5, 1, 1, 1, and 0.5, respectively.8 When one takes the ratio of all the flexors to all the extensors the
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