Reis Guilherme Henrique Teixeira, Carvalho Willker Galvão de, Rodrigues Mauricio Foster, Neto Jorge Raduan, Okamura Aldo, Belloti João Carlos
Departamento de Cirurgia da Mão, Hospital Alvorada, São Paulo, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Sep 4;59(4):e572-e579. doi: 10.1055/s-0044-1788289. eCollection 2024 Aug.
This study aimed to evaluate and compare the clinical and functional outcomes of two surgical procedures performed in patients with severe grade III and IV rhizarthrosis. We evaluated 39 patients who underwent two surgical techniques for rhizarthrosis treatment: trapeziectomy using the Kuhns technique or tendon interposition, with a minimum follow-up period of 6 months. The primary outcome assessment used the specific Trapeziometacarpal Arthrosis Symptoms and Disability (TASD) questionnaire, and the secondary outcome evaluation employed the shortened version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire and the visual analog scale (VAS). There was no statistically significant difference between groups in the TASD, QuickDASH, and VAS results, and both techniques demonstrated good functional and pain outcomes. No complication required a new surgical approach. We found a positive correlation between TASD and QuickDASH questionnaire scores, suggesting their effectiveness in assessing functionality and disability in subjects with rhizarthrosis. Trapeziectomy using the Kuhns technique and tendon interposition proved effective in the surgical treatment of rhizarthrosis. There was no significant difference between the techniques concerning functional outcomes.
本研究旨在评估和比较针对重度III级和IV级拇指关节病患者实施的两种外科手术的临床和功能结果。我们评估了39例接受两种拇指关节病治疗手术技术的患者：采用库恩斯技术的大多角骨切除术或肌腱植入术，最短随访期为6个月。主要结局评估使用特定的大多角骨-掌骨关节病症状与残疾（TASD）问卷，次要结局评估采用手臂、肩部和手部残疾简化版问卷（QuickDASH）以及视觉模拟量表（VAS）。两组在TASD、QuickDASH和VAS结果方面无统计学显著差异，且两种技术均显示出良好的功能和疼痛结局。没有并发症需要再次手术。我们发现TASD与QuickDASH问卷得分之间存在正相关，表明它们在评估拇指关节病患者的功能和残疾情况方面有效。采用库恩斯技术的大多角骨切除术和肌腱植入术在拇指关节病的外科治疗中被证明是有效的。两种技术在功能结局方面无显著差异。
