Angly B, Steiger R, Stober R
Handchirurgische Abteilung der Orthopädischen Klinik, Kantonsspital Liestal, Schweiz.
Handchir Mikrochir Plast Chir. 2006 Apr;38(2):90-7. doi: 10.1055/s-2006-924041.
We compare clinically and radiologically two groups of total trapezectomy performed as treatment for the primary osteoarthritis of trapeziometacarpal joint combined in 83 cases (2000 to 2003) with tendon interposition arthroplasty type Weilby, in 51 cases (1987 to 1991) with Epping tendon interposition and ligament reconstruction arthroplasty in a retrospective study. In both groups we used a strip of the flexor carpi radialis tendon. The mean follow-up time in both groups is 33 months. Overall, both methods achieved similar results. The relief of pain and the patient satisfaction are better, stability and grip force are worse in the Weilby group. At least one year (12 to 57 months) after operation with the technique of Weilby, 88 % of the patients would prefer this method for the other side. It appears that there is no clinical and radiological benefit of ligament reconstruction. However, the two procedures studied yield equally good results in most cases, but we prefer the simple technique of Weilby and guess that the (missing) long-term results would be superior to the results after trapezectomy alone. Long-term results need to be evaluated.
我们在一项回顾性研究中,对2000年至2003年采用韦尔比肌腱间置关节成形术治疗第1掌腕关节原发性骨关节炎的83例全大多角骨切除术患者,与1987年至1991年采用埃平肌腱间置和韧带重建关节成形术治疗的51例患者进行了临床和影像学比较。两组均使用桡侧腕屈肌腱条。两组的平均随访时间均为33个月。总体而言,两种方法取得了相似的结果。韦尔比组的疼痛缓解和患者满意度较好,稳定性和握力较差。采用韦尔比技术手术后至少一年(12至57个月),88%的患者会希望另一侧也采用这种方法。似乎韧带重建在临床和影像学上并无益处。然而,所研究的两种手术方法在大多数情况下效果相当,但我们更倾向于简单的韦尔比技术,并推测(缺失的)长期结果会优于单纯大多角骨切除术后的结果。长期结果有待评估。