Yamawaki Rie, Nankaku Manabu, Ikeguchi Ryosuke, Maeda Akemi, Noguchi Takashi, Matsuda Shuichi
Rehabilitation Unit, Kyoto University Hospital, Shogoin, Kyoto, Japan.
Department of Orthopedic Surgery, Kyoto University Graduate School of Medicine, Shogoin, Kyoto, Japan.
J Hand Surg Asian Pac Vol. 2025 Feb;30(1):70-76. doi: 10.1142/S2424835525500122. Epub 2024 Nov 29.
Thumb carpometacarpal (CMC) arthritis is a painful and debilitating condition, which in severe cases may be treated by surgery. Previous studies have emphasised the importance of rehabilitation following surgery to achieve optimal results. This study aimed to investigate whether intensive hand therapy is effective in improving hand functions after arthroscopic partial trapeziectomy with suture-button (SB) suspensionplasty in patients with thumb CMC arthritis. This was a retrospective observational study that used non-randomised historical controls. Patients who underwent arthroscopic partial trapeziectomy with SB suspensionplasty were divided into two groups according to whether they had postoperative hand therapy or not (hand therapy group, = 12; no hand therapy group, = 11). CMC joint pain, range of motion (ROM), grip and pinch strength in the operative side and Quick Disability of the Arm, Shoulder and Hand (QuickDASH) score were compared before surgery and at the final follow-up for each group. CMC joint pain, ROM and QuickDASH scores significantly improved following surgery, in both groups. Conversely, postoperative grip and pinch strength only increased significantly in the hand therapy group (grip strength: effect size = 0.36, pinch strength: effect size = 0.44). This study demonstrates that early-stage intensive hand therapy is an effective intervention after arthroscopic partial trapeziectomy with SB suspensionplasty, specifically for improving grip and pinch strength. Level III (Therapeutic).
拇指腕掌关节（CMC）关节炎是一种疼痛且使人衰弱的疾病，在严重情况下可通过手术治疗。先前的研究强调了术后康复对于取得最佳效果的重要性。本研究旨在调查强化手部治疗对于拇指CMC关节炎患者在关节镜下部分大多角骨切除术联合缝线纽扣（SB）悬吊成形术后改善手部功能是否有效。这是一项采用非随机历史对照的回顾性观察研究。接受关节镜下部分大多角骨切除术联合SB悬吊成形术的患者根据术后是否接受手部治疗分为两组（手部治疗组，n = 12；未接受手部治疗组，n = 11）。比较了每组手术前和最终随访时患侧的CMC关节疼痛、活动范围（ROM）、握力和捏力以及手臂、肩部和手部快速残疾量表（QuickDASH）评分。两组患者术后CMC关节疼痛、ROM和QuickDASH评分均显著改善。相反，仅手部治疗组术后握力和捏力显著增加（握力：效应量 = 0.36，捏力：效应量 = 0.44）。本研究表明，早期强化手部治疗是关节镜下部分大多角骨切除术联合SB悬吊成形术后的一种有效干预措施，尤其对于改善握力和捏力。III级（治疗性）。
