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中年女性腕掌关节切除-间置关节成形术后的功能与健康对照组比较。

Functionality of middle-aged women after resection-interposition arthroplasty of the trapeziometacarpal joint in comparison to a healthy control group.

机构信息

Handsurgery, Vulpius Klinik, Vulpiusstraße 29, 74906, Bad Rappenau, Germany.

出版信息

Arch Orthop Trauma Surg. 2014 May;134(5):735-9. doi: 10.1007/s00402-014-1966-z. Epub 2014 Mar 9.

Abstract

INTRODUCTION

Trapeziometacarpal joint osteoarthritis is a very common degenerative joint disease which affects especially women between their fifth and sixth decade of life. To determine the final pinch, grip and functional outcome after trapeziometacarpal arthroplasty and to compare to non-arthritic controls, we hypothesized that patients after the former surgery are expected to have lower grip and pinch strength and a higher DASH score.

MATERIALS AND METHODS

44 women (range 50-65 years of age; median 57 years of age) were examined after resection-interposition arthroplasty because of trapeziometacarpal joint osteoarthritis Eaton-Littler stage 3 and 4 with a minimum follow-up time of 12 months (range 12-99 months; median 47 months) using DASH questionnaire and grip and pinch strength evaluation. The control group consisted of 107 healthy age-matched controls (range 50-64 years of age; median 54 years of age). Differences between both groups were statistically analysed using analysis of covariance.

RESULTS

A significant loss of pinch strength and a significant higher DASH score were detected for the patient group in comparison to the controls, whereas grip strength did not differ significantly.

CONCLUSIONS

A loss of pinch strength in conjunction with a higher DASH score was detected. The expected loss of pinch strength in conjunction with a reduced physical functionality should be discussed preoperatively with the patient to meet the expectations and to offer the best suitable treatment option.

摘要

简介

腕掌关节骨关节炎是一种非常常见的退行性关节疾病,尤其影响 50 至 60 岁之间的女性。为了确定腕掌关节成形术后的最终捏力、握力和功能结果,并与非关节炎对照组进行比较,我们假设前者手术后的患者预计握力和捏力较弱,而 DASH 评分较高。

材料和方法

44 名女性(年龄 50-65 岁;中位数 57 岁)因腕掌关节骨关节炎 Eaton-Littler 3 期和 4 期接受切除-间置关节成形术,随访时间至少 12 个月(范围 12-99 个月;中位数 47 个月),使用 DASH 问卷和握力和捏力评估。对照组由 107 名年龄匹配的健康对照组(年龄 50-64 岁;中位数 54 岁)组成。使用协方差分析对两组之间的差异进行统计学分析。

结果

与对照组相比,患者组的捏力明显下降,DASH 评分明显升高,而握力无明显差异。

结论

与对照组相比,患者组的捏力明显下降,同时 DASH 评分升高。术前应与患者讨论捏力下降和身体功能下降的预期,以满足期望并提供最佳治疗选择。

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