case_images: PMC4623541_01
case_images: PMC4623541_02
case_images: Lateral preoperative x-rays. The patient demonstrates Z deformity and dislocation of first metacarpal. No arthritic changes are evident over the joint surfaces
case_images: icrp-2-007-g001.jpg
case_images: PMC4623541_02_icrp-2-007-g001.jpg
case_images: F0001
case_images: X-rays demonstrated no evidence of osteophytes or arthritic changes (See Figure 1).
case_images: Intraoperative photograph demonstrating pattern of dislocation.
case_images: icrp-2-007-g002.jpg
case_images: PMC4623541_02_icrp-2-007-g002.jpg
case_images: F0002
case_images: Ligamentous instability and dislocation is demonstrated (See Figures 2 and 3).
case_images: Intraoperative photograph demonstrating pattern of dislocation.
case_images: icrp-2-007-g003.jpg
case_images: PMC4623541_02_icrp-2-007-g003.jpg
case_images: F0003
case_images: Ligamentous instability and dislocation is demonstrated (See Figures 2 and 3).
case_images: Intraoperative photograph demonstrating 0.045 K-wire driven across the trapezium into the base of the thumb metacarpal from the dorsal and ulnar side of the metacarpal into the volar and radial side of the trapezium.
case_images: icrp-2-007-g004.jpg
case_images: PMC4623541_02_icrp-2-007-g004.jpg
case_images: F0004
case_images: Once the trajectory was planned, a 0.045 K-wire was then driven across the trapezium into the base of the thumb metacarpal (See Figure 4).
case_images: Intraoperative photograph demonstrating tightening of the Mini TightRope
case_images: icrp-2-007-g005.jpg
case_images: PMC4623541_02_icrp-2-007-g005.jpg
case_images: F0005
case_images: TightRope was tightened (See Figure 5). There was excellent stability of the CMC joint with no dorsal or ulnar dislocation. The Mini TightRope was tightened and tied (See Figure 6), and mini C-arm images were used to confirm proper alignment with lack of dislocation. The knot was buried dorsally and then the skin incisions were closed.
case_images: Intraoperative photograph demonstrating the final placement of fully deployed Mini TightRope.
case_images: icrp-2-007-g006.jpg
case_images: PMC4623541_02_icrp-2-007-g006.jpg
case_images: F0006
case_images: TightRope was tightened (See Figure 5). There was excellent stability of the CMC joint with no dorsal or ulnar dislocation. The Mini TightRope was tightened and tied (See Figure 6), and mini C-arm images were used to confirm proper alignment with lack of dislocation. The knot was buried dorsally and then the skin incisions were closed.
case_images: Fluoroscopic images confirming adequacy of reduction and appropriate placement of suture buttons.
case_images: icrp-2-007-g007.jpg
case_images: PMC4623541_02_icrp-2-007-g007.jpg
case_images: F0007
case_images: TightRope (See Figure 7). The patient was placed in a thumb spica splint, and discharged home.
case_images: Demonstration of appropriate functionality of hand and thumb-CMC interface. Patient demonstrates no residual dislocation or dorsal ulnar ligament laxity. Patient has appropriate movements associated with thumb-CMC joint, and has appropriate pinch and grip strength.
case_images: icrp-2-007-g008.jpg
case_images: PMC4623541_02_icrp-2-007-g008.jpg
case_images: F0008
case_images: At 6 weeks follow-up, the patient demonstrated continued stability of the thumb CMC joint without dorsal or radial dislocation, and demonstrated strong pinch and grip functionality (see Figures 8 and 9).
case_images: Demonstration of appropriate functionality of hand and thumb-CMC interface. Patient demonstrates no residual dislocation or dorsal ulnar ligament laxity. Patient has appropriate movements associated with thumb-CMC joint, and has appropriate pinch and grip strength.
case_images: icrp-2-007-g009.jpg
case_images: PMC4623541_02_icrp-2-007-g009.jpg
case_images: F0009
case_images: At 6 weeks follow-up, the patient demonstrated continued stability of the thumb CMC joint without dorsal or radial dislocation, and demonstrated strong pinch and grip functionality (see Figures 8 and 9).