Crosby E B, Linscheid R L, Dobyns J H
J Hand Surg Am. 1978 May;3(3):223-34. doi: 10.1016/s0363-5023(78)80086-0.
Scaphotrapezial trapezoidal degenerative arthritis as an isolated entity or as a preponderant part of a pantrapezial degenerative process was seen in 49 hands of 34 patients. Pain and weakness were the primary complaints. Point tenderness was present in all but two hands. Significant loss of grasp and pinch strength was noted in 18 hands, and loss of wrist motion occurred in 16 hands. Roentgenographic findings included narrowing of the scaphotrapezial trapezoidal joint space, subarticular cortical sclerosis, and cyst formation. A dorsiflexed position of the scaphoid, with a scapholunate angle of less than 45 degrees, was noted in 38 of the 45 hands. Late collapse of the intercarpal joint with dorsiflexion instability of the lunate also was noted. Twenty-nine hands were treated conservatively by protective splints, corticosteroid injections, and avoidance of exacerbating activities. Surgical treatments consisted of fibrous arthroplasty (four), silicone interposition arthroplasty (six), trapezial replacement arthroplasty (three), arthrodesis (five), joint debridement (one), and trapezial excision (one). Late results were more encouraging than were early results and were moderately satisfactory for each method. Improvement in grasp and pinch strength was most predictable for arthrodesis, although wrist motion was diminished.
舟大多角小多角关节退行性关节炎作为一种独立病症或作为全大多角关节退行性病变的主要部分，在34例患者的49只手中被发现。疼痛和无力是主要症状。除两只手外，其余所有手部均有压痛点。18只手出现显著的抓握力和捏力丧失，16只手出现腕关节活动度丧失。X线表现包括舟大多角小多角关节间隙变窄、关节下皮质硬化和囊肿形成。45只手中的38只手可见舟骨背屈位，舟月角小于45度。还发现腕骨间关节晚期塌陷伴月骨背屈不稳定。29只手采用保护性夹板、皮质类固醇注射及避免加重活动等保守治疗。手术治疗包括纤维关节成形术（4例）、硅胶置入关节成形术（6例）、大多角骨置换关节成形术（3例）、关节融合术（5例）、关节清创术（1例）和大多角骨切除术（1例）。晚期结果比早期结果更令人鼓舞，每种方法的效果都较为满意。关节融合术对抓握力和捏力的改善最可预测，不过腕关节活动度会减小。
