Garvey Jay, Gargasz Scott
Advanced Hand and Plastic Surgery Center, 4710 N Habana Ave STE 100, Tampa, FL, 33614, USA.
, Lutz, FL, 33548, USA.
J Med Case Rep. 2025 Jun 18;19(1):281. doi: 10.1186/s13256-025-05351-7.
Shaping the trapezium and metacarpal base during first carpometacarpal (CMC) Ensemble arthroplasty traditionally relies on manual rasping. This is time-consuming and poses the risk of iatrogenic nerve injury due to repeated rasping near the dorsal and volar branches of the dorsal radial sensory nerve. This case report presents a novel modification to the surgical technique by integrating a mini power saw to streamline joint space preparation.
A 56-year-old Caucasian female patient presented with advanced first carpometacarpal osteoarthritis and chronic pain. She underwent multiple rounds of corticosteroid injections into the first carpometacarpal joint that provided only short-term relief. She expressed her desire for long-term relief and underwent Ensemble arthroplasty at the first carpometacarpal with this modification to the technique. Intraoperative fluoroscopy confirmed optimal implant positioning. The patient began occupational therapy 2 weeks post-surgery, attending sessions two to three times per week.
This innovative approach reduced operative time by 20 minutes compared to traditional rasping, with postoperative outcomes comparable to those of the standard technique. This report highlights a potential advancement in surgical efficiency and safety.
在第一掌腕关节（CMC）全腕关节置换术中，传统上依靠手动锉削来塑造大多角骨和掌骨基底。这很耗时，并且由于在桡神经背侧感觉神经的背侧和掌侧分支附近反复锉削，存在医源性神经损伤的风险。本病例报告介绍了一种对手术技术的新颖改进，即集成微型电锯以简化关节间隙准备。
一名56岁的白种女性患者患有晚期第一掌腕关节骨关节炎和慢性疼痛。她接受了多轮第一掌腕关节皮质类固醇注射，仅获得了短期缓解。她表示希望获得长期缓解，并接受了对该技术进行此改进的第一掌腕关节全腕关节置换术。术中透视确认植入物定位最佳。患者在术后2周开始接受职业治疗，每周参加两到三次治疗。
与传统锉削相比，这种创新方法将手术时间缩短了20分钟，术后结果与标准技术相当。本报告强调了手术效率和安全性方面的潜在进展。
