Moneim Moheb S, Salas Christina, Lese Andrea B, Thompson Norfleet B, Mercer Deana M
Orthopedics. 2018 Mar 1;41(2):e228-e233. doi: 10.3928/01477447-20180123-03. Epub 2018 Jan 29.
The purpose of this study was to describe long-term outcomes of partial trapeziectomy with capsular interposition (PTCI) arthroplasty for patients with osteoarthritis of the basal joint of the thumb. A total of 27 patients (20 women, 7 men; 32 thumbs) with a mean age of 61 years (range, 47-74 years) agreed to return for follow-up and were included in the study. Mean postoperative follow-up was 64.3 months (range, 28-112 months). Evaluation included tests for grip and pinch strength; range of motion of the metacarpophalangeal joint; measurement of the first web space; completion of the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire; visual analog scale (VAS) measurements; and radiographic examination of the hand. A paired, 2-tailed t test was used to determine statistical significance (P<.05) of pre- and postoperative values. Postoperative values for grip strength were significantly increased from preoperative values. No significant loss of pinch strength was noted. Excessive hyperextension of the metacarpophalangeal joint did not occur, and the first web space was maintained. The mean DASH questionnaire and VAS scores were 5.06 (range, 0-26.5) and 0.32, respectively. Use of PTCI arthroplasty resulted in minimal loss in thumb height (7%) and significantly reduced thumb metacarpal subluxation (13%). There were no reported complications. The low DASH questionnaire and VAS scores compare well with other studies and indicate good functional outcomes. In treating thumb basal joint osteoarthritis, use of PTCI arthroplasty may result in improved thumb stability and grip strength, minimal subsidence of the thumb metacarpal, and reduced joint subluxation. [Orthopedics. 2018; 41(2):e228-e233.].
本研究的目的是描述采用带关节囊嵌入的部分大多角骨切除术（PTCI）关节成形术治疗拇指基底关节骨关节炎患者的长期疗效。共有27例患者（20例女性，7例男性；32侧拇指）同意返回接受随访并纳入本研究，平均年龄61岁（范围47 - 74岁）。术后平均随访64.3个月（范围28 - 112个月）。评估包括握力和捏力测试；掌指关节活动范围；第一掌骨间隙测量；完成手臂、肩部和手部功能障碍（DASH）问卷；视觉模拟量表（VAS）测量；以及手部X线检查。采用配对双尾t检验确定术前和术后值的统计学显著性（P<0.05）。术后握力值较术前显著增加。未观察到捏力显著下降。掌指关节未出现过度伸直，第一掌骨间隙得以维持。DASH问卷平均得分和VAS得分分别为5.06（范围0 - 26.5）和0.32。采用PTCI关节成形术导致拇指高度最小程度降低（7%），拇指掌骨半脱位显著减少（13%）。未报告并发症。低DASH问卷得分和VAS得分与其他研究相比情况良好，表明功能结局良好。在治疗拇指基底关节骨关节炎时，采用PTCI关节成形术可能会改善拇指稳定性和握力，减少拇指掌骨下沉，并减少关节半脱位。[《骨科》。2018年；41(2):e228 - e233。]
