Comparative Outcomes of Oblique vs. Transverse Bone Tunnels in Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis

Abstract

This retrospective non-randomized study aimed to compare the clinical and radiological outcomes of oblique versus transverse tunnels in ligament reconstruction and tendon interposition arthroplasty. This study included 15 patients with oblique tunnels (Group 1) and 13 patients with transverse tunnels (Group 2), all of whom had been diagnosed with Eaton stage 3 or 4 carpometacarpal arthritis and had undergone trapeziectomy with the ligament reconstruction and tendon interposition surgery. The visual analogue scale was used to assess pain levels, while the Quick Disabilities of the Arm, Shoulder and Hand questionnaire was used to evaluate functional limitations in activities of daily living. Preoperative and postoperative radiological findings as well as the thumb range of motion, grip strength, key pinch strength, and tip pinch strength were measured. Demographic data and complications were also documented. The change in Quick Disabilities of the Arm, Shoulder and Hand scores in Group 1 was significantly greater than that in Group 2. No significant differences were found between the two groups in visual analogue scale changes, range of motions, pinch strength assessments, or any radiological outcomes. In the treatment of thumb carpometacarpal joint arthritis with the ligament reconstruction and tendon interposition surgery, the oblique tunnel orientation in the ligament reconstruction and tendon interposition surgery for thumb carpometacarpal arthritis improves the Quick Disabilities of the Arm, Shoulder and Hand score, but does not significantly affect pain, complications, or radiological outcomes. These findings provide important insights for the selection of tunnel orientation in ligament reconstruction and tendon interposition applications.

Zusammenfassung

Ziel dieser retrospektiven, nicht-randomisierten Studie ist es, die klinischen und radiologischen Ergebnisse von schrägen im Vergleich zu transversalen Knochentunneln bei der LRTI-Arthroplastik zu vergleichen. In diese Studie wurden 15 Patienten mit schrägem Tunnel (Gruppe 1) und 13 Patienten mit transversalem Tunnel (Gruppe 2) einbezogen, bei denen eine Rhizarthrose im Stadium 3 oder 4 nach Eaton diagnostiziert wurde und die sich einer Trapezektomie mit LRTI (Ligament Reconstruction and Tendon Interposition) unterzogen hatten. Zur Schmerzbewertung wurde die visuelle Analogskala (VAS) verwendet, während mit dem Quick-DASH (Disabilities of the Arm, Shoulder and Hand) funktionelle Einschränkungen im Alltag erfasst wurden. Prä- und postoperative radiologische Befunde sowie Bewegungsumfang des Daumens, Greifkraft, Schlüsselgriff- und Spitzgriffkraft wurden gemessen. Demografische Daten und Komplikationen wurden ebenfalls dokumentiert. Die Veränderung der Quick-DASH-Werte war in Gruppe 1 signifikant größer als in Gruppe 2. Zwischen den Gruppen zeigten sich keine signifikanten Unterschiede hinsichtlich der VAS-Veränderungen, der Beweglichkeit, der Greif- oder der Pinzettengriffkraft sowie der radiologischen Ergebnisse. Bei der Behandlung der Rhizarthrose mittels LRTI-Chirurgie verbessert die schräge Tunnelführung den Quick-DASH-Score signifikant, hat jedoch keinen signifikanten Einfluss auf Schmerz, Komplikationen oder radiologische Befunde. Diese Ergebnisse liefern wichtige Erkenntnisse für die Wahl der Tunnelorientierung bei LRTI-Eingriffen.

Keywords

Hand surgery - Microsurgery - Laser - Transverse tunnel - Ligament reconstruction - Oblique tunnel - Carpometacarpal arthritis

Schlüsselwörter

Rhizarthrose - Bandrekonstruktion - Schrager Knochentunnel - Transverse tunnel - Transverser Knochentunnel

Publication History

Received: 20 July 2025

Accepted: 20 December 2025

Article published online:
25 February 2026

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