Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
Eur J Trauma Emerg Surg. 2022 Apr;48(2):1225-1230. doi: 10.1007/s00068-020-01577-w. Epub 2020 Dec 24.
The primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose of the present study was to introduce a variation of the abductor pollicis longus (APL) suspension arthroplasty using a single looping of a radial slip from the APL tendon around the flexor carpi radialis (FCR) tendon combined with RegJoint™ interposition and to determine its efficacy in the treatment of thumb CMC joint osteoarthritis.
Between 2015 and 2017, 21 patients were included. The average age was 60.8 years (range 48-79). The mean follow-up was 27.7 months (range 8-50). Evaluation included pain, radial and palmar abduction, tip pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score.
Pain averaged 0.3 (range 0-4) at rest and 1.4 (range 0-4) on exertion. The radial and palmar abduction were 97% and 99% compared to the contralateral side. The tip pinch and grip strength were 4.1 kg (range 3-6.5) and 22 kg (range 13.3-40), respectively. The DASH score accounted for 18.5 (range 0.8-41.7).
The modified APL suspension interposition arthroplasty was an efficient and simplified option for the treatment of thumb CMC joint osteoarthritis, with results comparable or better than other published procedures. The APL suspension technique was easy to perform avoiding difficult bone tunneling and incision of the FCR tendon. The RegJoint™ interposition as spacer prevented impingement of the first metacarpal base on the second metacarpal base or the trapezoid bone.
晚期拇指腕掌（CMC）关节骨关节炎的主要治疗目标是完全缓解疼痛和恢复拇指力量。本研究的目的是介绍一种改良的拇长展肌（APL）悬吊关节成形术，即通过 APL 肌腱围绕屈肌支持带（FCR）肌腱的单一环形滑动，结合 RegJoint™ 间置物，并确定其在治疗拇指 CMC 关节骨关节炎中的疗效。
2015 年至 2017 年期间，共纳入 21 例患者。平均年龄为 60.8 岁（范围 48-79 岁）。平均随访时间为 27.7 个月（范围 8-50 个月）。评估包括疼痛、桡侧和掌侧外展、指尖捏力和握力以及上肢残疾问卷（DASH）评分。
休息时疼痛平均为 0.3（范围 0-4），活动时疼痛平均为 1.4（范围 0-4）。桡侧和掌侧外展分别为对侧的 97%和 99%。指尖捏力和握力分别为 4.1kg（范围 3-6.5kg）和 22kg（范围 13.3-40kg）。DASH 评分为 18.5（范围 0.8-41.7）。
改良的 APL 悬吊间置物关节成形术是治疗拇指 CMC 关节骨关节炎的一种有效且简化的选择，其结果与其他已发表的手术方法相当或更好。APL 悬吊技术易于操作，避免了 FCR 肌腱的骨隧道和切口困难。RegJoint™ 间置物作为间隔物可防止第一掌骨基底撞击第二掌骨基底或梯形骨。
