第一掌骨延长截骨术治疗腕掌关节骨关节炎的长期疗效
Long-term outcomes of first metacarpal extension osteotomy in the treatment of carpal-metacarpal osteoarthritis.
作者信息
Parker Wendy L, Linscheid Ronald L, Amadio Peter C
机构信息
Mayo Clinic, Rochester, MN, USA.
出版信息
J Hand Surg Am. 2008 Dec;33(10):1737-43. doi: 10.1016/j.jhsa.2008.08.003.
PURPOSE
The purpose of this study was to investigate the long-term outcomes of first metacarpal extension osteotomy in the treatment of osteoarthritis of the thumb carpal-metacarpal joint.
METHODS
We retrospectively reviewed 8 patients treated by a single surgeon with first metacarpal extension osteotomy.
RESULTS
Preoperative Eaton stage was I in 3 patients, II in 3 patients, and III in 2 patients. Mean follow-up was 9 years (range, 6-13 years). Average lateral pinch strength, oppositional pinch strength, and grip strength were measured as 5 kg, 3 kg, and 19 kg, respectively (129%, 103%, and 108% of contralateral). Eaton stage was preserved in 5 of the 8 patients, with excellent functional outcomes in 6 of 8 patients at a mean of 9 years.
CONCLUSIONS
Our data suggest that first metacarpal extension osteotomy can be an effective and durable procedure that does not limit future salvage procedures such as trapeziectomy or arthroplasty and support use of this treatment in early and moderate Eaton stages.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
目的
本研究旨在探讨第一掌骨伸展截骨术治疗拇指腕掌关节骨关节炎的长期疗效。
方法
我们回顾性分析了由单一外科医生采用第一掌骨伸展截骨术治疗的8例患者。
结果
术前伊顿分期，3例为I期，3例为II期，2例为III期。平均随访9年（范围6 - 13年）。平均侧捏力、对捏力和握力分别为5kg、3kg和19kg（分别为对侧的129%、103%和108%）。8例患者中有5例维持了伊顿分期，8例患者中有6例在平均9年时获得了良好的功能结局。
结论
我们的数据表明，第一掌骨伸展截骨术可能是一种有效且持久的手术方法，不会限制未来诸如大多角骨切除术或关节成形术等挽救性手术，并支持在伊顿早期和中期阶段采用这种治疗方法。
研究类型/证据水平：治疗性IV级。
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