Szalay G, Schleicher I, Alt V, Pavlidis T, Schnettler R
Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Rudolf-Buchheim-Str. 7, D-35385, Giessen, Deutschland.
Orthopade. 2011 Mar;40(3):237-46. doi: 10.1007/s00132-010-1729-7.
Rhizarthritis is the most common form of arthritis of the hand with a frequency of 10% and conservative as well as surgical methods of treatment are available. The aim of this study was to compare the results of resection suspension arthroplasty according to Epping with trapezium replacement using pyrocarbon spacers.
Between January 2001 and December 2008 a total of 84 patients were surgically treated for rhizarthritis in our clinic. Of these patients 12 were treated with other surgical procedures, 40 with resection suspension arthroplasty according to Epping and 32 with pyrocarbon spacers as trapezium replacement. The patients were examined in a retrospective study and success of treatment was evaluated according to the Buck-Gramcko criteria.
According to the evaluation criteria over 80% of patients in both collectives achieved very good or good operative results with the same degree of satisfaction.
The results of this study confirm the value of resection suspension arthroplasty according to Epping for surgical treatment of rhizarthritis. Using trapezectomy with interposition of pyrocarbon spacers good or very good results can be achieved in the majority of cases. Essential points of criticism are the current material cost of 930 Euros and 4 dislocations in our collective but with good multiaxial movement and loading capacity. Comparable results using alternative procedures indicate that the results of further studies and long-term results will be decisive for establishment of this operational procedure.
拇指关节炎是手部最常见的关节炎形式，发病率为10%，有保守和手术治疗方法。本研究的目的是比较根据埃平法进行的切除悬吊成形术与使用热解碳间隔物进行大多角骨置换的结果。
2001年1月至2008年12月，我院共对84例拇指关节炎患者进行了手术治疗。其中12例采用其他手术方法治疗，40例根据埃平法进行切除悬吊成形术，32例使用热解碳间隔物进行大多角骨置换。对患者进行回顾性研究，并根据巴克-格拉姆科标准评估治疗效果。
根据评估标准，两个组中超过80%的患者获得了非常好或良好的手术效果，满意度相同。
本研究结果证实了根据埃平法进行的切除悬吊成形术在拇指关节炎手术治疗中的价值。采用大多角骨切除术并植入热解碳间隔物，大多数病例可获得良好或非常好的效果。主要批评点是目前930欧元的材料成本以及我们组中的4例脱位，但具有良好的多轴运动和承载能力。使用替代手术方法获得的可比结果表明，进一步研究的结果和长期结果将对确立该手术方法起决定性作用。
