Kenesi C, Artières X
Hôpital Henri Mondor, Créteil.
Chirurgie. 1996;121(6):487-91.
There is no ideal surgical indication for rhizoarthrosis of the trapezoid-metacarpal joint. Fusion using two screws or a screw and a pin allow solidification after minimal immobilization for 45 days with the thumb placed in front of the index. A 1 to 21 year follow-up (mean 68 months) of 30 hands showed 23 cases of arthrosis and 7 cases of polyarthritis. Overall results were good in 17 cases, acceptable in 8 and poor in 5. Pain relief was obtained or improved in 90% of the cases. Radiographically, pseudarthrosis was seen in 10%. No reoperations were required. Fusion is an alternative to other surgical approaches allowing pain relief and solid grip without the major problems related to prostheses.
大多角骨-第一掌骨关节的关节病没有理想的手术指征。使用两枚螺钉或一枚螺钉和一枚钢针进行融合,在将拇指置于示指前方进行最少45天的固定后可实现牢固愈合。对30只手进行了1至21年的随访(平均68个月),结果显示有23例关节病和7例多关节炎。总体结果为17例良好,8例可接受,5例较差。90%的病例疼痛得到缓解或改善。影像学检查显示10%的病例存在假关节。无需再次手术。融合术是其他手术方法的一种替代选择,可缓解疼痛并实现有力握持,且不存在与假体相关的重大问题。