Faour-Martín Omar, Martín-Ferrero Miguel Ángel, Valverde-García Jose Antonio, Vega-Castrillo Aurelio, De La Red-Gallego María Ángeles
Complejo Hospitalario De Ávila-Sacyl, Spain.
Int J Surg Case Rep. 2013;4(10):929-32. doi: 10.1016/j.ijscr.2013.07.028. Epub 2013 Aug 13.
Restoration of thumb function with a painfree, stable, and mobile joint with preserved strength are the main goals of treatment of painful arthritis of the thumb. We present our clinical experience in surgical treatment of this disease, in its highest degree of affectation.
A 57-year-old woman presents with a 2-year history of worsening pain at the base of her right, dominant, trapezial-metacarpal (TM) joint. Her thumb metacarpophalangeal (MCP) joint hyperextends 30° with lateral pinch. Radiographs demonstrate Eaton stage IV degenerative changes of her TM joint and no arthritis of her thumb MCP joint. She was successfully treated with a modified Burton-Pellegrini arthroplasty and sesamoidesis to the metacarpal head.
In cases of advanced rhizarthrosis conventional surgery does not serve to correct deformities of the metacarpophalangeal joint that may affect to the postsurgical outcomes.
rhizarthrosis management must be carried out in a global way. When a surgical treatment is planned, all deformities must be taken into account.
恢复拇指功能，使其关节无痛、稳定且可活动，并保留力量，是拇指疼痛性关节炎治疗的主要目标。我们介绍了我们在这种疾病最高程度受累时的手术治疗临床经验。
一名57岁女性，其优势手（右手）的大多角骨-第一掌骨（TM）关节基部疼痛加剧已有2年病史。她的拇指掌指（MCP）关节在侧捏时过度伸展30°。X线片显示其TM关节处于伊顿IV期退行性改变，拇指MCP关节无关节炎。她接受了改良的伯顿-佩莱格里尼关节成形术及第一掌骨头籽骨植入术，治疗成功。
在晚期拇指关节炎病例中，传统手术无法矫正可能影响术后效果的掌指关节畸形。
拇指关节炎的治疗必须全面进行。在计划进行手术治疗时，必须考虑所有畸形情况。
