Yeh Kuang-Ting, Wang Jen-Hung, Li Jochieh, Shih Jui-Tien
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan.
School of Medicine, Tzu Chi University, Hualien 970374, Taiwan.
J Clin Med. 2025 Jun 10;14(12):4118. doi: 10.3390/jcm14124118.
Carpometacarpal thumb arthritis causes pain and functional limitations. : This study evaluated the efficacy of arthroscopic partial trapeziectomy with free palmar longus tendon suspension and interpositional arthroplasty, combined with a soft anchor internal brace, for the treatment of thumb basal joint arthritis. Between August 2010 and April 2020, 60 thumbs with symptomatic basal joint arthritis (Eaton stage II-III) were treated using this minimally invasive technique. : The cohort included 52 female and 8 male patients (mean age, 62.6 ± 4.3 years), who underwent clinical follow-up for 28.7 ± 3.0 months. VAS pain scores decreased from 5.7 ± 0.5 to 1.0 ± 0.7 and 7.1 ± 0.6 to 1.4 ± 0.9 ( < 0.001) during rest and activity, respectively. Thumb range of motion increased from 43.3 ± 11.3 to 54.2 ± 9.8 degrees, while pinch strength improved from 47.3 ± 9.5% to 88.8 ± 17.3% of the contralateral side ( < 0.001). Patients with Eaton stage II disease demonstrated better outcomes than those with stage III disease. Radiographically, minimal proximal migration of the first metacarpal (mean, 1.2 mm) was observed, with no cases of scaphotrapezial joint arthritis. : Arthroscopic partial trapeziectomy with tendon suspension/interposition and an internal brace is an effective treatment for Eaton stage II-III basal joint arthritis, offering significant pain relief, functional improvement, and joint stability, while preserving the scaphotrapezial joint.
拇指腕掌关节关节炎会导致疼痛和功能受限。本研究评估了关节镜下部分大多角骨切除术联合游离掌长肌腱悬吊和间置关节成形术，并结合软锚内固定支架治疗拇指基底关节关节炎的疗效。2010年8月至2020年4月期间，采用这种微创技术治疗了60例有症状的基底关节关节炎（伊顿II - III期）拇指。该队列包括52名女性和8名男性患者（平均年龄62.6±4.3岁），临床随访时间为28.7±3.0个月。静息和活动时视觉模拟评分（VAS）疼痛评分分别从5.7±0.5降至1.0±0.7以及从7.1±0.6降至1.4±0.9（P<0.001）。拇指活动范围从43.3±11.3度增加到54.2±9.8度，捏力从对侧的47.3±9.5%提高到88.8±17.3%（P<0.001）。伊顿II期疾病患者的疗效优于III期疾病患者。影像学检查显示，第一掌骨近端仅有轻微移位（平均1.2毫米），未出现舟大多角关节关节炎病例。关节镜下部分大多角骨切除术联合肌腱悬吊/间置及内固定支架是治疗伊顿II - III期基底关节关节炎的有效方法，可显著缓解疼痛、改善功能并保持关节稳定性，同时保留舟大多角关节。
