<p><strong>Background</strong>: The purpose of this study is to assess the functional outcome of the cases with advanced thumb carpometacarpal (CMC) arthritis treated with trapeziectomy and ligament reconstruction tendon interposition (LRTI) in terms of visual analogue scale (VAS), disabilities of the arm, shoulder and hand (DASH) score, Kapandji score, range of motion (ROM) of radial and volar abduction of the thumb, grip power, key pinch and the height of the trapezial space.</p><p><strong>Methods</strong>: In a prospective before and after interventional study of 30 patients with the advanced thumb CMC joint arthritis underwent the procedure. An average follows up period was 17.9 months.</p><p><strong>Results:</strong> The mean VAS decreased from 8.17 to 2.70. The mean Kapandji score and DASH score improved from 3.47 and 71.62 preoperative to 8.23 and 14.46 postoperative.  Mean ROM for radial and volar abduction increased from 42.57° and 48° to 61°and 64.73° respectively. Mean key pinch power and grip power increased from 2.80 kg and 3.47 kg to 4.70 kg and 9.01 kg respectively.  There was a significant decrease in height of the trapezial space. Three patient complaint of the persistent pain at the surgical site and not much improvement in the DASH score.</p><p><strong>Conclusions:</strong>  Trapeziectomy with LRTI using flexor carpi radialis (FCR) transfer is an effective treatment for the advanced thumb CMC arthritis. This procedure stabilizes thumb metacarpal and provide enough support which prevents the collapse of metacarpal into dead space.</p>

<p>Ulnar nerve compression at the Guyon’s canal is an uncommon cause of ulnar nerve neuropathy. Among various reasons like trauma, non-union of hook of hamate, anomalous muscle anatomy, thrombosis of the ulnar artery or pseudoaneurysm, ganglion is a common lesion which can compress the ulnar nerve at this site. With proper history taking and physical examination consisting of assessing motor functions and sensation of the hand, a clinician can localize the site of the lesion. Ultrasound is cheap and non-invasive technique which helps to localize the site of lesion and can suggest the nature of the lesion. Surgical decompression of the canal and careful removal of the lesion can help ameliorate the symptoms. In our study the patient presented with sudden onset weakness of the right hand and symptoms progressing within one and half month. With proper muscle charting, sensory examination and with the help of sonography, the main culprit was localized to Guyon’s canal. Excision of the lesion helped in recovery of hand function within 5 months.</p>