Primary Thumb Carpometacarpal Osteoarthritis – Ligament Reconstruction Arthroplasty (Weilby Technique)

Authors of this study performed the Weilby sling procedure for base of thumb osteoarthritis. There have been no previous studies conducted that provide pre and post-operative, subjective and objective outcomes using this technique.

There are several operations used to treat base of thumb osteoarthritis (OA), many of which focus on removing the trapezium.

The Weilby technique involves removing the trapezium and filling the space with a tendon sling. The tendon graft is a third of the flexor carpi radialis and is used as a sling to hold the surrounding structures in place, in turn keeping the first metacarpal from subluxing.

Nineteen patients were identified (twenty thumbs in total) for this study. The DASH (disabilities of arm, shoulder and hand) outcome data collection was used for subjective assessment pre- and post operative at three, six and twelve months. A more specific, personal questionnaire was completed at the twelve month follow-up. This included grip strength, and was measured pre-operatively, and at three and six months. Range of movement was also measured.

The patients' thumb pain had significantly improved at twelve months. DASH scores improved significantly with seventeen out of nineteen patients satisfied. Overall range of movement had no significant difference or improvement. Overall grip strength was significantly improved at twelve months (some more significantly than others). It is a reliable procedure that does not require a bone tunnel to be created, as well as achieving pain relief, stability, mobility and strength.

Mike Hayton practices this technique for surgery on base of thumb osteoarthritis. His findings are similar and in agreement with that of the study.

G.M. Vermeules, F.M. Brink, J. Sluiter, F.G. Elias, S.E.R. Hovius, T.M. Moojen
Journal of Hand Surgery 2009, 34A, 1393-1401. The Department of Hand and Wrist Surgery, Netherlands.