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Resection-Suspension Arthroplasty according to Epping for Rhizarthrosis

hand surgery
Reading time readingtime 08:51 min.
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Planning/Incision

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    Anatomical orientation by palpation and marking of anatomical landmarks:

    • 1. ECF = Extensor tendon compartment
    • 1. CMC joint (thumb saddle joint) = Carpometacarpal joint
    • STT joint = Scaphotrapeziotrapezoidal joint

    Longitudinal skin incision dorsally over the saddle joint with arc-shaped extension proximally over the 1st ECF. Sharp transection of the subcutis under bipolar coagulation of individual veins.

  2. Exposure of the Trapezium Bone from the Palmar Side

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    Successive exposure of the trapezium bone with the adjacent joints (1st CMC joint, ST joint). The radial artery crossing over the trapezium bone is dissected free and provided with a rubber sling, so that it can be safely spared during the operation.

    (CMC joint = Carpometacarpal joint, 1st CMC = Thumb saddle joint; ST joint = Scaphotrapezoidal joint)

    Caution

    • Cutaneous branches of the R. dorsalis N. radialis or N. cutaneus antebrachii medialis
    • A. radialis
Resection of the Trapezium Bone (Trapeziectomy)

First, the joint capsule of the saddle joint is opened longitudinally, the trapezium is detached al

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