Abstract
Background Arthritis of the first carpometacarpal (CMC) joint has been surgically treated in
multiple ways with varying levels of success as measured by subjective and objective
measures. Trapeziectomy with numerous variations in suspensionplasty comprises one
of the more commonly used surgical procedures. Recently, the Mini TightRope apparatus
has been utilized as a new method for achieving suspensionplasty, and as such lacks
significant review of use and safety in the literature.
Case Description An extensor pollicis longus (EPL) rupture following a trapeziectomy and Mini TightRope
suspensionplasty for CMC arthritis of the thumb is presented. The patient successfully
underwent an extensor indicis proprius (EIP) to EPL transfer to treat this complication.
Literature Review There is well-established documentation of injury to the extensor tendons from orthopedic
hardware such as volar locking plates. Regarding use of the Mini TightRope apparatus,
guidelines for placement of the suture button include caution to place the button
away from the EPL tendon to minimize the chance of tendon irritation. Additionally,
FiberWire sutures, a component of the apparatus, have been shown to demonstrate soft
tissue reactions with adjacent inflammatory response. Published reports on adverse
events utilizing this device have been limited to case reports including an index
metacarpal fracture.
Clinical Relevance The aim of this case report was to cite an occurrence of EPL rupture following its
use and discuss the possibilities of its direct contribution.
Keywords
EPL rupture - Mini TightRope - suspensionplasty - trapeziectomy
