• Silvan M Klein, Katharina Wachter, Michael Koller, Jody Vykoukal, Sebastian Geis, Juergen H Dolderer, Markus Loibl, and Lukas Prantl.
• Center of Plastic-, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. silvan.klein@klinik.uni-regensburg.de.
• Arch Orthop Trauma Surg. 2015 Oct 1; 135 (10): 1475-84.

IntroductionThumb trapeziometacarpal joint (TMJ) arthritis is among the most common degenerative joint diseases of the hand and predominantly affects patients in their fifth or sixth decade of life. Mid-term results of the most common surgical procedures were inconclusive regarding the superiority of one particular treatment method. This study presents the long-term outcomes of a modified Epping procedure.MethodsSeventy-one patients underwent a modified Epping procedure with a flexor carpi radialis (FCR) tendon sling stabilizer. After a mean follow-up of 13 years, 39 patients were followed by questionnaire and 15 patients presented for clinical examination. Outcomes were evaluated by objective clinical measurements, radiographic evaluations, performance in DASH, as well as patients' perceived level of handicap during defined exercises.ResultsMean DASH score was 32.39. Within the cohort, 66.7 % of the patients were free of complaints. Among patients reporting complaints, perceived loss of strength was the main concern for the majority (15.4 %) of study participants. Grip and pinch strengths and range of motion did not differ significantly between operated and non-operated hands. One patient suffered rupture of ligament plasty and needed revision surgery.ConclusionDespite relatively high DASH scores, the overall outcome of the modified Epping procedure is encouraging. Subjective loss of strength is a main complaint among patients, whereas instability is less of concern.

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