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掌腕关节骨关节炎患者术前及术后拇指运动的三维运动分析-融合术与关节切除和悬吊成形术的比较。

Three-dimensional motion analysis of pre- and postoperative thumb movement in trapeziometacarpal joint osteoarthritis-Comparison of arthrodesis and trapeziectomy with suspensionplasty.

机构信息

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Laboratory of Analysis and Control of Upper Extremity Function, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

出版信息

PLoS One. 2024 May 16;19(5):e0302898. doi: 10.1371/journal.pone.0302898. eCollection 2024.

Abstract

Trapeziometacarpal osteoarthritis (TMC-OA) reduces the range of motion (ROM) of the thumb. However, the kinematic change achieved through surgical treatment remains unclear. Therefore, to quantify the kinematic change following TMC-OA surgery, we performed a three-dimensional motion analysis of the thumb using an optical motion capture system preoperatively and 1 year postoperatively in 23 patients with TMC-OA scheduled for arthrodesis (AD) or trapeziectomy with suspensionplasty (TS). Eighteen hands of nine healthy volunteers were also included as controls. Both procedures improved postoperative pain and Disability of the Arm, Shoulder and Hand scores, and AD increased pinch strength. The ROM of the base of the thumb was preserved in AD, which was thought to be due to the appearance of compensatory movements of adjacent joints even if the ROM of the TMC joint was lost. TS did not improve ROM. Quantifying thumb kinematic changes following TMC-OA surgery can improve our understanding of TMC-OA treatment and help select surgical procedures and postoperative assessment.

摘要

掌腕关节骨关节炎(TMC-OA)会降低拇指的活动范围(ROM)。然而,手术治疗所达到的运动学变化仍不清楚。因此,为了量化 TMC-OA 手术后的运动学变化,我们使用光学运动捕捉系统对 23 例计划行关节融合术(AD)或关节切开术伴悬吊成形术(TS)的 TMC-OA 患者的拇指进行了术前和术后 1 年的三维运动分析。还包括 9 名健康志愿者的 18 只手作为对照组。两种手术都改善了术后疼痛和上肢功能障碍评分,AD 还增加了捏力。AD 保留了拇指基部的 ROM,这被认为是由于即使 TMC 关节的 ROM 丧失,相邻关节的代偿运动的出现。TS 并没有改善 ROM。量化 TMC-OA 手术后拇指的运动学变化可以帮助我们更好地理解 TMC-OA 的治疗方法,并有助于选择手术程序和术后评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f796/11098354/3a4515e82b27/pone.0302898.g001.jpg

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