Garcia-Elias Marc
Institut Kaplan, Barcelona, Spain.
J Hand Surg Am. 2011 Mar;36(3):516-20. doi: 10.1016/j.jhsa.2010.12.016.
Symptomatic scaphotrapeziotrapezoidal (STT) joint osteoarthritis may occasionally require surgery. In the absence of dorsal midcarpal instability, acceptable results may be obtained by an excisional STT joint arthroplasty. After distal scaphoid resection, however, forces are no longer transmitted along the radial column of the wrist. This often results in slight malrotation of the proximal row into extension. To mitigate this problem, different strategies have been proposed (dorsal midcarpal capsulodesis, palmar radioscaphoid capsulodesis, tendon interposition, or pyrocarbon implant interposition). As compared to STT fusion, excisional arthroplasty is less technically demanding, requires less prolonged immobilization, and has fewer complications.
有症状的舟大多角小多角（STT）关节骨关节炎偶尔可能需要手术。在没有背侧中腕关节不稳定的情况下，通过切除性STT关节置换术可能会获得可接受的结果。然而，在切除舟骨远端后，力量不再沿腕部的桡侧柱传递。这通常会导致近端排向伸展方向轻微旋转不良。为了缓解这个问题，已经提出了不同的策略（背侧中腕关节囊固定术、掌侧桡舟关节囊固定术、肌腱植入或热解碳植入物植入）。与STT融合术相比，切除性关节置换术对技术要求较低，需要的固定时间较短，并发症也较少。
