Vinycomb Toby, Crock John
Department of Surgery, Monash Medical Centre, Monash University, Australia.
Hand Surg. 2013;18(3):365-8. doi: 10.1142/S0218810413500408.
To investigate the long-term (> 10 yrs) outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI).
We reviewed 15 cases of trapeziectomy with LRTI performed for the treatment trapeziometacarpal osteoarthritis. Mean follow up was 13.5 yrs (range, 10.5-17.5 yrs). We assessed a number of subjective and objective outcomes. A good outcome was a participant who did not require revision surgery, was satisfied with the outcome of their surgery and did not experience rest pain.
No patients had revision surgery and only two patients were unsatisfied or very unsatisfied with the outcome of their surgery. Pain with activity was the strongest predictor of participant satisfaction.
Approximately half the participants in this study experienced good long-term outcomes. Some participants were experiencing long-term symptoms, particularly pain, despite reporting that they are satisfied with the outcome of their surgery. Alternative techniques should be investigated that provide superior long-term outcomes.
探讨采用韧带重建与肌腱间置术(LRTI)的大多角骨切除术的长期(>10年)疗效。
我们回顾了15例行LRTI大多角骨切除术治疗大多角掌骨关节骨关节炎的病例。平均随访时间为13.5年(范围10.5 - 17.5年)。我们评估了多项主观和客观疗效指标。良好疗效定义为无需翻修手术、对手术结果满意且无静息痛的患者。
无患者接受翻修手术,仅有2例患者对手术结果不满意或非常不满意。活动时疼痛是患者满意度的最强预测因素。
本研究中约半数参与者获得了良好的长期疗效。尽管一些参与者表示对手术结果满意,但仍有部分人存在长期症状,尤其是疼痛。应研究能提供更优长期疗效的替代技术。