Schibli-Beer S, Mark G, Canova M
Handchirurgie, Kantonsspital Graubünden, Chur, Schweiz.
Handchir Mikrochir Plast Chir. 2008 Jun;40(3):169-74. doi: 10.1055/s-2007-989389. Epub 2008 Jun 11.
Resection arthroplasty of the carpometacarpal joint of the thumb is considered to be the most frequently used surgical treatment for osteoarthritis of the trapeziometacarpal joint. Although simple trapeziectomy and fixation of the capsular tissue have been found to be an easy, successful treatment, the ligament reconstruction and tendon interposition in different techniques is still widely used. We evaluate the results of our patients after simple trapeziectomy.
Thirty-four thumbs were treated by simple trapeziectomy and fixation of the dorsal capsular tissue. If the dorsal capsular tissue seemed to be weak, it was fixed with a mitek anchor (Minilok Quickanchor, De Puy Mitek, Raynham, USA) to the distal scaphoid pole. Assessment included patient satisfaction, pain measurement, range of motion and tip, key and grip strength.
After a mean follow-up of 26.9 (8-61) months, 91% were satisfied with the outcome, 94.1% would undergo the procedure again. 41% of the patients reported complete pain relief, 44% had pain only with large mechanical load. At follow-up, the mean DASH score was 29.2 (+/-21.7). We noticed in 29% paraesthesia at the back of the thumb, suggesting damage to branches of the superficial radial nerve. Furthermore, we tried two easy functional tests: 91% of the patients could hold a cup of coffee without any pain, 76.4% could hold a one-litre bottle without pain.
The collected data confirm that the simple trapeziectomy is a safe and relative simple procedure for treatment of carpometacarpal osteoarthritis of the thumb.
拇指腕掌关节切除成形术被认为是大多角骨-第一掌骨关节骨关节炎最常用的手术治疗方法。尽管单纯大多角骨切除术和关节囊组织固定术已被证明是一种简单、成功的治疗方法，但不同技术中的韧带重建和肌腱植入仍被广泛应用。我们评估了单纯大多角骨切除术后患者的治疗效果。
对34例拇指采用单纯大多角骨切除术及背侧关节囊组织固定术进行治疗。如果背侧关节囊组织看起来薄弱，则用米特克锚钉（Minilok Quickanchor，美国德普伊米特克公司，雷纳姆）固定于舟骨远端极。评估内容包括患者满意度、疼痛测量、活动范围以及指尖、关键和握力。
平均随访26.9（8 - 61）个月后，91%的患者对治疗结果满意，94.1%的患者愿意再次接受该手术。41%的患者报告疼痛完全缓解，44%的患者仅在承受较大机械负荷时疼痛。随访时，平均DASH评分为29.2（±21.7）。我们注意到29%的患者拇指背侧有感觉异常，提示桡神经浅支分支受损。此外，我们尝试了两项简单的功能测试：91%的患者能无痛握住一杯咖啡，76.4%的患者能无痛握住一升装瓶子。
收集的数据证实，单纯大多角骨切除术是治疗拇指腕掌关节骨关节炎的一种安全且相对简单的手术。
