Hatta Taku, Goto Hitoshi, Sonofuchi Kazuaki, Nobuta Shingo, Toh Satoshi, Itoi Eiji
Goto Orthopedic Hand Clinic, Miyagi.
Department of Orthopaedic Surgery, Tohoku Rosai Hospital.
Orthop Rev (Pavia). 2021 Mar 31;13(1):9085. doi: 10.4081/or.2021.9085. eCollection 2021 Mar 30.
The purposes of this study were to demonstrate the clinical characteristics of patients with persistent second carpometacarpal (CMC) joint pain without bony abnormalities known as the carpal boss, and to assess the clinical efficacy of surgical stabilization of the second CMC joint. Eleven patients had persistent wrist pain with characteristic symptoms, including tenderness over the second CMC joint, increased symptoms when the involved hand was placed on the ground or gripped strongly with the involved hand, a positive metacarpal stress test and temporary pain relief with the intra-articular injection of the lidocaine. The patients underwent arthrodesis of the second CMC joint. All cases showed radiologically confirmed fusion of the second CMC joint. At the final followup examination, 10 of 11 patients resulted in satisfactory clinical outcomes, excepting one patient with remnant pain and restricted range of wrist motions. This report highlights the importance of conducting a careful assessment of patients who present with persistent second CMC joint pain without the bony abnormalities, such as carpal bossing. Surgery to stabilize the second CMC joint may be an option to improve their symptoms when conservative treatment fails.
本研究的目的是阐明患有持续性第二掌腕（CMC）关节疼痛且无骨质异常（即腕部隆起）患者的临床特征，并评估第二CMC关节手术稳定术的临床疗效。11例患者有持续性腕部疼痛及特征性症状，包括第二CMC关节压痛、患手着地或用力抓握时症状加重、掌骨应力试验阳性以及关节内注射利多卡因后疼痛暂时缓解。这些患者接受了第二CMC关节融合术。所有病例经影像学检查证实第二CMC关节融合。在末次随访检查时，11例患者中有10例临床结果满意，仅1例患者仍有残余疼痛且腕部活动范围受限。本报告强调了对出现持续性第二CMC关节疼痛且无骨质异常（如腕部隆起）的患者进行仔细评估的重要性。当保守治疗失败时，第二CMC关节稳定手术可能是改善其症状的一种选择。
