Martini A K
Z Orthop Ihre Grenzgeb. 1985 Jan-Feb;123(1):44-53. doi: 10.1055/s-2008-1045107.
Surgical treatment of rhizarthrosis is indicated in progression of the symptoms and increase of functional restriction despite conservative treatment. The etiopathogenesis of genuine arthrosis has not yet been clarified completely. Recent investigations show the great importance of the first intercarpal ligament for the stability of the basal joint of the thumb and its important role in the development of arthrosis. Several surgical measures are available to us and require differentiated establishment of the indication. First of all, there is trapezektomy with and without tendon interposition; this enables an improvement of symptoms. However, the increasing shortening of the thumb and the weakness and limitation to movement associated with this is to be regarded as disadvantageous. A surgical technique for restoration of the ligament connection between the first and the second metacarpalia after extirpation of the trapezium is presented. The results of this method are compared with those of the conventional technique. In all 12 of a total of 20 hands operated on in this way, the proximal displacement of the first metacarpum could be largely prevented. The remaining clinical parameters are also convincing.
尽管进行了保守治疗，但如果症状仍在进展且功能受限加重，则表明需要对拇指掌指关节病进行手术治疗。真性关节病的病因尚未完全阐明。最近的研究表明，第一腕骨间韧带对拇指基底关节的稳定性非常重要，并且在关节病的发展中起重要作用。我们有几种手术方法可供选择，需要对适应症进行差异化确定。首先，有带或不带肌腱植入的大多角骨切除术；这可以改善症状。然而，拇指逐渐缩短以及与之相关的无力和运动受限被认为是不利的。本文介绍了一种在切除大多角骨后恢复第一和第二掌骨之间韧带连接的手术技术。将该方法的结果与传统技术的结果进行了比较。用这种方法进行手术的20只手中，有12只手的第一掌骨近端移位在很大程度上得到了预防。其余的临床参数也很有说服力。
