Raptis Konstantinos, Koutserimpas Christos, Bavelou Aikaterini, Fandridis Emmanouil, Spyridonos Sarantis
Hand-Upper Limb-Microsurgery Department, General Hospital KAT, Athens, Greece.
Department of Orthopaedics and Traumatology, "251" Hellenic Air Force General Hospital of Athens, Greece.
Maedica (Bucur). 2021 Sep;16(3):415-419. doi: 10.26574/maedica.2021.16.3.415.
Isolated scaphotrapeziotrapezoidal (STT) joint osteoarthritis (OA) is a relatively common condition. Scaphotrapeziotrapezoidal arthrodesis is the traditional treatment, while excisional arthroplasty with the use of flexor carpi radialis (FCR) or polycarbon implants represents a promising alternative surgical management. The present study aims to assess a novel alternative technique of excisional arthroplasty with the use of palmaris longus (PL) tendon as interposition material. The present research is a retrospective observational study. Patients suffering from symptomatic isolated STT OA, without midcarpal instability and treated with excisional arthroplasty with the use of PL tendon as interposition material, were evaluated. Five patients (two males and three females) with mean age of 63.8 years [standard deviation (SD)=16.9] were included. The mean follow up was 56.4 months (SD=9.8). In order to quantify the clinical results, we used the preoperative and postoperative visual analogue scale (VAS) score at rest and during activity, abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score and postoperative ROM. The postoperative VAS score at rest and during activity showed a decrease of 86.2% and 62.5%, respectively, when compared to the preoperative one. Regarding postoperative ROM at final follow-up, patients had a mean wrist flexion 71° compared to 78° of the contralateral hand, while the mean extension was found to be 57° compared to 66° of the contralateral side. The evaluated novel technique with the use of PL tendon as interposition material seems to offer satisfying results, while allowing to keep the FCR tendon intact. More studies comparing these techniques are of utmost importance to conclude which is the optimal treatment.
孤立性舟大多角小多角（STT）关节骨关节炎（OA）是一种相对常见的病症。舟大多角小多角关节融合术是传统的治疗方法，而使用桡侧腕屈肌（FCR）或聚碳酸酯植入物的切除性关节成形术是一种有前景的替代手术治疗方式。本研究旨在评估一种使用掌长肌（PL）肌腱作为植入材料的新型切除性关节成形术替代技术。本研究是一项回顾性观察研究。对患有症状性孤立性STT OA、无腕中关节不稳且接受使用PL肌腱作为植入材料的切除性关节成形术治疗的患者进行了评估。纳入了5例患者（2例男性和3例女性），平均年龄为63.8岁[标准差（SD）=16.9]。平均随访时间为56.4个月（SD=9.8）。为了量化临床结果，我们使用了术前和术后静息及活动时的视觉模拟量表（VAS）评分、简化版上肢、肩部和手部功能障碍（QuickDASH）评分以及术后活动范围（ROM）。与术前相比，术后静息和活动时的VAS评分分别下降了分别为86.2%和62.5%。在末次随访时，患者的平均腕关节屈曲角度为71°，对侧手为78°，平均伸展角度为57°，对侧为66°。使用PL肌腱作为植入材料的评估新技术似乎能提供令人满意的结果，同时能保持FCR肌腱完整。比较这些技术的更多研究对于确定哪种是最佳治疗方法至关重要。
