Demir Erhan, Wittemann Michael, Germann Günter, Sauerbier Michael
Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, Plastic and Hand Surgery of the University of Heidelberg, Ludwigshafen, Germany.
Ann Plast Surg. 2005 Feb;54(2):147-52. doi: 10.1097/01.sap.0000143607.46558.7a.
Surgical treatment of idiopathic postmenopausal osteoarthrosis of the trapeziometacarpal joint with the Epping resection arthroplasty was performed in 57 cases in 49 women. Data show good pain relief (between 58% and 76%), very good subjective results with 89% patient satisfaction and Disability of Arm, Shoulder, Hand (DASH) scores in the lower third of the scale after 35 months' follow-up. Good functional results with respect to radial abduction (51 degrees) and palmar flexion (45 degrees), as well as improvement in strength measurements, could be achieved. Some patients (13%) reported remaining problems with occasional pain during performance of activities of daily life and work. A significant proximal metacarpal migration (31%) without correlation to objective or subjective outcome was found. The Epping procedure has proven to be a valuable alternative procedure to treat idiopathic postmenopausal trapeziometacarpal arthrosis after a midterm follow-up period. Still, careful patient selection is important and sufficient preoperative information necessary.
对49名女性的57例患者采用埃平切除术对绝经后特发性大多角骨-第一掌骨关节病进行了手术治疗。数据显示疼痛缓解良好（58%至76%），主观结果非常好，患者满意度达89%，随访35个月后上肢、肩部和手部功能障碍（DASH）评分处于量表下半部分。在桡侧外展（51度）和掌屈（45度）方面取得了良好的功能结果，力量测量也有所改善。一些患者（13%）报告在日常生活和工作活动中仍偶尔存在疼痛问题。发现有明显的第一掌骨近端移位（31%），且与客观或主观结果无关。中期随访后，埃平手术已被证明是治疗绝经后特发性大多角骨-第一掌骨关节病的一种有价值的替代手术。尽管如此，仔细选择患者很重要，术前提供充分信息也很必要。
