Dhar S, Gray I C, Jones W A, Beddow F H
Department of Orthopaedic Surgery, Royal Liverpool University Hospital, UK.
J Hand Surg Br. 1994 Aug;19(4):485-8. doi: 10.1016/0266-7681(94)90214-3.
We have reviewed the results in 34 patients (39 operations) following simple excision of the trapezium for osteoarthritis of the basal joint of the thumb. The average age at operation was 57 years and the average follow-up was 6 years. All the patients were graded clinically and radiologically and were asked their opinion of the procedure. There was dramatic relief of pain following this procedure. Stability of the thumb was not compromised. When compared to the unoperated side, thumb length, thumb abduction and first web span were similar. There was a reduction in pinch strength (operated 8.1 k.p.a., non-operated 9.6 k.p.a.) and grip strength (operated 15.5 k.p.a., non-operated 19.5 k.p.a.) and an increase in MIP extension (operated 5.4 degrees, non-operated 2.9 degrees) following this procedure but the differences were not statistically significant. 11 patients (32%) had scar hyperaesthesia on testing but this was a clinical problem in two patients only (5%). Simple excision of the trapezium is a satisfactory procedure for the majority of patients with this disorder, but has a long post-operative rehabilitation period.
我们回顾了34例患者（共39次手术）单纯切除大多角骨治疗拇指腕掌关节骨关节炎的结果。手术时的平均年龄为57岁，平均随访时间为6年。所有患者均进行了临床和影像学分级，并询问了他们对该手术的看法。该手术后疼痛明显缓解。拇指的稳定性未受影响。与未手术侧相比，拇指长度、拇指外展和第一掌骨间隙相似。该手术后捏力（手术侧8.1千帕，未手术侧9.6千帕）和握力（手术侧15.5千帕，未手术侧19.5千帕）有所降低，最大被动伸展度增加（手术侧5.4度，未手术侧2.9度），但差异无统计学意义。11例患者（32%）检查时存在瘢痕感觉过敏，但仅2例患者（5%）存在临床问题。对于大多数患有这种疾病的患者来说，单纯切除大多角骨是一种令人满意的手术，但术后康复期较长。
