Complications - Resection-Suspension Arthroplasty according to Epping for Rhizarthrosis

• Lesion of radial artery
• Lesion/Severing of FCR
• Lesion of the branches of the superficial branch of the radial nerve as well as the medial antebrachial cutaneous nerve
• Incomplete removal of the trapezium
• Fracturing of the bone during drilling

Management 

• Primary microsurgical nerve or artery suture 
• Careful exposure of the bone and its osteophytes. Control of the resection by palpation of the surgical area, if necessary, fluoroscopy control
• If possible, reconstruction of the FCR tendon and change of procedure (trapeziectomy alone, if necessary with fixation of the 1st metacarpal bone using K-wires to the 2nd and 3rd metacarpals)
• In case of fracturing, change of procedure with suspension by partial transfer of the APL (Abductor pollicis longus tendon)

Acute Complications

• Bleeding/Hematoma
• Infection/Wound Healing Disorder

Management

• for relevant hematoma operative revision
• for infection immediate operative revision
• for wound healing disorder operative revision according to severity of findings

Late Complications

• Loss of Suspension of the Metacarpal I Base
• Protracted Scar Pain/Neuroma Pain
• Restriction of Movement
• CRPS (Sudeck's Disease)

Management

• in case of loss of suspension and corresponding complaints consider suspension by wire suture (e.g. Tightrope®)
• for scar pain/neuroma pain/neuropathic pain watchful waiting, possibly desensitization therapy
• for neuroma pain with adhesions neurolysis, microsurgical reconstruction and neuroma resection; Ultima ratio: high resection of the R. superficialis N. radialis at the level of the proximal forearm
• for CRPS appropriate therapy of the disease (see specialist literature)