Wittemann M, Demir E, Sauerbier M, Germann G
Klinik für Hand, Plastische und Rekonstruktive Chirurgie, Schwerbrandverletztenzentrum, Universität Heidelberg, Germany.
Handchir Mikrochir Plast Chir. 2002 Jan;34(1):49-58. doi: 10.1055/s-2002-22108.
The surgical treatment of painful osteoarthrosis of the trapeziometacarpal joint with the Epping technique consists of excision of the trapezium and reconstruction of the first intermetacarpal ligament by using the distally based half of the flexor carpi radialis tendon. This ligament reconstruction procedure aims to prevent proximal migration of the first metacarpal, restore function and stability of the neoarthros. This retrospective study presents operative outcome results after using the Epping arthroplasty technique. The Epping technique has been performed in seventy cases and could be evaluated after a mean follow-up of 34.6 months in 92.4 % of all operated patients. Subjective results were evaluated using patient-based questionnaires such as the Buck-Gramcko-Score and the German Version of the DASH V2.0 questionnaire. Objective and functional outcome analysis including range of motion, strength measurements with the computer-based JAMAR dynamometer and various X-ray views, have been used as further methods of evaluation. Excellent pain relief and very good subjective results with 86 % patient satisfaction have been reported by our patients. The objective outcome analysis demonstrated good functional results with respect to radial abduction (51 degrees) and palmar flexion (45 degrees), and improvement in grip strength, key pinch and pulp pinch. Some patients reported remaining problems with pain during performance of activities of daily life and professional activities. A significant proximal metacarpal migration without correlation to the objective or subjective outcome was found in follow-up X-ray controls. The Epping ligament reconstruction procedure has proven to be a valuable standard procedure after a mid-term follow-up period. Good functional outcome and high patient satisfaction could be achieved, but some patients still remain with problems in different activities. Long-term results still need to be evaluated.
采用埃平技术对大多角骨-第一掌骨关节疼痛性骨关节炎进行手术治疗，包括切除大多角骨，并利用桡侧腕屈肌腱远侧半部分重建第一掌骨间韧带。该韧带重建手术旨在防止第一掌骨近端移位，恢复新关节的功能和稳定性。这项回顾性研究展示了使用埃平关节成形术技术后的手术结果。埃平技术已应用于70例患者，在92.4%的手术患者中，平均随访34.6个月后可进行评估。主观结果采用基于患者的问卷进行评估，如巴克-格拉姆科评分和德文版DASH V2.0问卷。客观和功能结果分析包括活动范围、使用基于计算机的JAMAR测力计进行力量测量以及各种X线片，作为进一步的评估方法。我们的患者报告疼痛得到显著缓解，主观结果非常好，患者满意度达86%。客观结果分析显示，在桡侧外展（51度）和掌屈（45度）方面功能结果良好，握力、关键捏力和指尖捏力有所改善。一些患者报告在日常生活活动和职业活动中仍存在疼痛问题。在随访X线检查中发现有明显的第一掌骨近端移位，且与客观或主观结果无关。中期随访后，埃平韧带重建手术已被证明是一种有价值的标准手术。可以实现良好的功能结果和较高的患者满意度，但仍有一些患者在不同活动中存在问题。长期结果仍需评估。
