Conolly W B, Lanzetta M
Sydney Hospital Hand Unit, New South Wales, Australia.
Aust N Z J Surg. 1993 Aug;63(8):596-603. doi: 10.1111/j.1445-2197.1993.tb00465.x.
In the years 1970-90, 118 procedures were performed on 100 patients with arthritis (osteoarthritis in all but 13) of the carpo-metacarpal joint of the thumb. The patients were aged 17 to 83 years (mean 54.5 years); 75 were females and 25 males; there were 73 right and 45 left hands; 18 patients had bilateral procedures. The average follow up period was 4.3 years, with a range of 1 to 20 years. Sixteen of the 118 procedures were arthrodeses; all these patients had isolated trapezio-metacarpal joint arthritis. Fifteen procedures were trapeziectomies and soft tissue arthroplasties; they were performed for pan-trapezial arthritis in the older age group, or as a secondary procedure for failed previous operations. Eighty-seven of the 118 procedures were silicone partial or total arthroplasties either for pan-trapezial arthritis or isolated trapezio-metacarpal joint arthritis (53 trapezium, 32 metatarso-phalangeal and 2 condyle implants). The overall results were: arthrodesis (68.7% good, 18.8% fair, 12.5% poor); soft tissue arthroplasty (80% good, 6.7% fair, 13.3% poor); silicone total arthroplasty (73.5% good, 15.1% fair, 11.3% poor); silicone hemiarthroplasty (68.8% good, 15.6% fair, 15.6% poor). No silicone synovitis was found in any of the 87 cases of silicone arthroplasties.
1970年至1990年间，对100例拇指腕掌关节关节炎患者（除13例为其他类型关节炎外，其余均为骨关节炎）实施了118例手术。患者年龄在17岁至83岁之间（平均54.5岁）；女性75例，男性25例；右手73例，左手45例；18例患者接受了双侧手术。平均随访期为4.3年，范围为1至20年。118例手术中有16例为关节融合术；所有这些患者均患有孤立性大多角骨-掌骨关节关节炎。15例手术为大多角骨切除术和软组织关节成形术；这些手术用于老年组的全大多角骨关节炎，或作为先前手术失败后的二次手术。118例手术中有87例为硅胶部分或全关节成形术，用于全大多角骨关节炎或孤立性大多角骨-掌骨关节关节炎（53例大多角骨植入、32例掌指关节植入和2例髁植入）。总体结果为：关节融合术（优68.7%，良18.8%，差12.5%）；软组织关节成形术（优80%，良6.7%，差13.3%）；硅胶全关节成形术（优73.5%，良15.1%，差11.3%）；硅胶半关节成形术（优68.8%，良15.6%，差15.6%）。87例硅胶关节成形术中均未发现硅胶滑膜炎。
