Ayache Ali, Spies Christian K, Unglaub Frank, Langer Martin F
Abteilung für Handchirurgie, Vulpius Klinik, Vulpiusstr. 29, 74906, Bad Rappenau, Deutschland.
Sektion Handchirurgie, Spital Langenthal, Spital Region Oberaargau SRO AG, Langenthal, Schweiz.
Orthopade. 2022 Jan;51(1):65-78. doi: 10.1007/s00132-021-04200-x. Epub 2022 Jan 10.
Due to the crucial role of the thumb for gripping, osteoarthritis of the first carpometacarpal joint leads to a substantial impairment of hand function. There are effective nonoperative and joint-preserving surgical treatment options for early stages of the disease. In advanced cases, after exploiting conservative treatment, carpometacarpal thumb arthrodesis or arthroplasty may be indicated in selected cases but trapeziectomy with or without interposition or suspension constitutes the gold standard surgical procedure. This reliably provides favorable results, irrespective of the technique, with pain relief, good physical function, excellent patient global assessment and low complication rates.
由于拇指在抓握中起着关键作用,第一掌腕关节的骨关节炎会导致手部功能严重受损。对于该疾病的早期阶段,有有效的非手术和保留关节的手术治疗选择。在晚期病例中,在采用保守治疗后,部分病例可能需要进行掌腕拇指关节融合术或关节成形术,但带或不带间置或悬吊的大多角骨切除术是金标准手术方法。无论采用何种技术,这都能可靠地带来良好效果,包括缓解疼痛、良好的身体功能、出色的患者总体评估以及低并发症发生率。