Szalay G, Scheufens T, Alt V, Boecker W, Schnettler R
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universität Giessen, Giessen.
Handchir Mikrochir Plast Chir. 2014 Jun;46(3):179-85. doi: 10.1055/s-0034-1368715. Epub 2014 Jun 18.
The aim of this work was to examine the utility of the Mini TightRope(®) after trapezectomy and suspension of the first metacarpal in cases of clinically manifest rhizarthrosis.
31 Patients (26 female, 5 male, mean age 57.9 years) with primary rhizarthrosis were treated with a trapezectomy and suspension of the first metacarpal with a Mini TightRope(®) (cost 225 Euro). In the course of a retrospective study, all patients underwent a clinical and radiological re-examination at an average of 13.5 (6-22) months. To assess the therapy, a clinical and radiological examination as well as the score of Buck-Gramcko were used.
74.2% of the patients obtained good and very good results, 12.9% achieved satisfactory or poor outcomes. In 2 patients the Mini Tight-Rope(®) had to be removed due to a proximalisation of the first metacarpal and strong pain in rest and motion after 6-7 months. Whereas the distance between the distal scaphoid pole and the base of the first metacarpal postoperatively averaged 11.1 (8-14) mm, it averaged 5.3 (0-10.2) mm in the follow-up examination.
With the presented procedure it is possible to achieve in the majority of the treated patients good and very good results. 2 early removals of the implants, a documented proximalisation in spite of the implant and the price of the Mini TightRope(®) of currently 225 Euro need to be discussed critically.
本研究旨在探讨Mini TightRope（®）在第一掌骨切除并悬吊治疗临床明显的拇指关节病中的应用价值。
31例原发性拇指关节病患者（26例女性，5例男性，平均年龄57.9岁）接受了第一掌骨切除并使用Mini TightRope（®）进行悬吊治疗（费用225欧元）。在一项回顾性研究过程中，所有患者平均在13.5（6 - 22）个月时接受了临床和影像学复查。为评估治疗效果，采用了临床和影像学检查以及Buck - Gramcko评分。
74.2%的患者获得了良好及非常好的效果，12.9%的患者效果满意或较差。2例患者因第一掌骨近端移位以及术后6 - 7个月静息和活动时剧痛，不得不取出Mini Tight - Rope（®）。术后舟骨远端极与第一掌骨基底之间的距离平均为11.1（8 - 14）mm，而在随访检查中平均为5.3（0 - 10.2）mm。
采用本手术方法，大多数接受治疗的患者能够获得良好及非常好的效果。但需要审慎讨论2例早期取出植入物的情况、尽管有植入物仍出现的记录在案的近端移位以及目前价格为225欧元的Mini TightRope（®）。
