Klamath Orthopedic Clinic, Klamath Falls, OR, USA.
Department of Orthopedic Surgery Oklahoma University and INTEGRIS Baptist Medical Center, Oklahoma City, OK, USA.
Hand (N Y). 2023 May;18(3):478-483. doi: 10.1177/15589447211017221. Epub 2021 Jun 2.
Thumb trapeziometacarpal (TM) joint arthrosis is a common cause of thumb pain, which adversely affects hand function. Early arthrosis is characterized by capsular laxity, painful pinch and grip, and physical findings of joint tenderness and laxity. Dorsoradial capsulodesis (DRC) is a surgical technique used to stabilize the TM joint and treat early-stage arthrosis. We aim to evaluate the clinical outcomes of DRC for treating trapeziometacarpal instability in early-stage disease.
Between 2003 and 2019, 23 patients underwent DRC. Patients with stage I TM arthritis and more than 6-month postoperative follow-up were included. Pain and disability scores were calculated along with physical examination and radiographic evaluation at the final follow-up.
At mean postoperative follow-up of 43.5 months, 13 patients with a mean age of 39.1 years were examined. The mean Disabilities of the Arm, Shoulder, and Hand score was 5.7, and visual analog pain score was 0.5. Patients had no significant difference in strength or range of motion in the ipsilateral versus contralateral hand. Follow-up radiographs did not demonstrate arthritic changes.
Dorsoradial capsulodesis is a technically simple and reasonable option for stabilizing the TM joint in patients with early-stage arthrosis. This intervention showed no midterm progression to advanced arthritis in this cohort.
拇指腕掌（TM）关节关节炎是引起拇指疼痛的常见原因，会对手部功能产生不利影响。早期关节炎的特征是囊带松弛、捏握疼痛、关节压痛和松弛。背侧桡侧囊紧缩术（DRC）是一种用于稳定 TM 关节和治疗早期关节炎的手术技术。我们旨在评估 DRC 治疗早期 TM 关节不稳定的临床效果。
2003 年至 2019 年间，有 23 例患者接受了 DRC 手术。纳入具有 I 期 TM 关节炎且术后随访超过 6 个月的患者。在最终随访时通过体格检查和影像学评估计算疼痛和残疾评分。
平均术后随访 43.5 个月时，对 13 例平均年龄为 39.1 岁的患者进行了检查。平均上肢功能障碍评分（DASH）为 5.7，视觉模拟疼痛评分（VAS）为 0.5。患侧与健侧手的力量或活动范围无明显差异。随访 X 线片未显示关节炎改变。
DRC 是稳定早期关节炎患者 TM 关节的一种技术简单且合理的选择。在该队列中，这种干预措施在中期没有进展为晚期关节炎。
