Haematoma distraction arthroplasty

Trapeziectomy in which the thumb metacarpal is held distracted, usually with a temporary K-wire, so that the space left by the trapezium fills with haematoma and then scar, without a tendon sling or interposition. The scaphoid–metacarpal distance falls with time, but this has not correlated with strength or function.

Related terms

• Treatment

  Trapeziectomy

  Removal of the trapezium so that the worn thumb-base joint no longer exists; the space fills with scar tissue and the thumb settles slightly. The standard operation for painful thumb-base arthritis, with good pain relief in about four in five people at five to eighteen years; pinch strength does not return to normal. Adding a tendon sling or spacer makes little or no difference.

• Treatment

  Ligament reconstruction and tendon interposition

  An addition to trapeziectomy in which a strip of a forearm tendon is used to make a sling for the thumb metacarpal and to fill the space left by the trapezium. Trials pooled in the 2026 Cochrane review show it makes little or no difference to pain, function or complications compared with trapeziectomy alone, and complications were about 19 in 100 against 10 in 100.

Articles mentioning this term

1. FESSH preparation · 2 October 2026

   Thumb-base osteoarthritis: trapeziectomy versus arthroplasty

   Trapeziectomy versus joint replacement for thumb-base osteoarthritis: ligament anatomy, Eaton staging, the randomised trials, implant survival and salvage.

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