Uriburu I J, Olazábal A E, Ciaffi M
Hand Surgical Service, Buenos Aires University Medical School, Argentina.
J Hand Surg Am. 1992 Jul;17(4):598-604. doi: 10.1016/0363-5023(92)90301-5.
Since 1973, 212 hands of 179 patients with disabling trapeziometacarpal osteoarthritis were treated with resection-arthroplasty stabilized by capsuloplasty and intermetacarpal ligament construction; 159 patients (180 hands) could be followed up (average, 7.8 years; range, 1 to 17.3 years). Pain relief was excellent in 89%, good in 10%, and fair in 1%. Patients were "delighted" (78%), "satisfied" (18%), "indifferent" (2%), or "disappointed" (2%) with their functional results. Palmar abduction improved 25%. The tip of the thumb reached the fifth metacarpophalangeal joint in 97% of the hands. Grip strength improved 29%; key pinch, 19%; pulp pinch, 24%. First metacarpal was stable in 94% of the cases. Scaphometacarpal space averaged 5.5 mm. There were three complete failures (2%); complications were mild and infrequent. Because of its good, predictable results, "stabilized resection-arthroplasty" is our preferred surgical treatment for osteoarthritic trapeziometacarpal joints.
自1973年以来，对179例患有致残性大多角骨-第一掌骨骨关节炎的患者的212只手进行了切除关节成形术治疗，该手术通过关节囊成形术和掌骨间韧带重建实现稳定；159例患者（180只手）获得随访（平均7.8年；范围1至17.3年）。疼痛缓解情况为：优89%，良10%，中1%。患者对功能结果“欣喜”（78%）、“满意”（18%）、“ indifferent”（2%）或“失望”（2%）。掌侧外展改善25%。97%的手拇指尖可触及第五掌指关节。握力提高29%；捏力提高19%；指尖捏力提高24%。94%的病例第一掌骨稳定。大多角骨-第一掌骨间隙平均为5.5毫米。有3例完全失败（2%）；并发症轻微且少见。由于其良好且可预测的结果，“稳定切除关节成形术”是我们治疗骨关节炎性大多角骨-第一掌骨关节的首选手术方法。
