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G Pomares, D Delgrande, F Dap, G Dautel
HYPOTHESIS: The aim of this article is to analyze clinical and radiological outcomes of trapeziectomy performed for basal thumb arthritis after a minimum follow-up of 10 years to gain further insight from shorter and medium-term studies reporting satisfactory evolution. METHODS: We reviewed 67 trapeziectomies, operated on by the same senior surgeon after a minimum follow-up of 10 years. The sample included 16 cases of suspensionplasty and 51 interpositions. Clinical outcome evaluated strength, pain, joint amplitude, Kapandji opposition score, Disabilities of the Arm, Shoulder and Hand score, complications and revision surgery...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
C Agout, L Ardouin, P Bellemère
Surgical management of carpometacarpal osteoarthritis may use many techniques. Pi2 (pyrocarbon interposition implant) arthroplasty is one possible solution after total trapeziectomy. The present study assessed clinical and radiological results in Pi2 arthroplasty at a minimum 10years' follow-up. Forty-two consecutive cases underwent surgery between March 2003 and April 2005; 29 were followed up for a mean of 125.49months (10.5years). A total of 96.6% of patients were very satisfied or satisfied. Range of motion improved, especially in opposition (mean Kapandji score, 9...
September 2016: Hand Surgery and Rehabilitation
A-M Gay, A Cerlier, A Iniesta, R Legré
Trapeziometacarpal (TMC) osteoarthritis is a common, disabling condition that mostly affects women. The demand for surgical treatment is growing and the patients are becoming younger, adding to the challenge. Surgery can only be proposed after failure of well-conducted conservative treatment and requires a complete X-ray assessment. In the early stages, conservative surgery measures can be used to stabilize the joint or realign it in cases of dysplasia, but in most cases, patients are seen with more advanced arthritis and joint replacement must be considered...
September 2016: Hand Surgery and Rehabilitation
Anita Sadhu, Ryan P Calfee, Andre Guthrie, Lindley B Wall
PURPOSE: To test the null hypothesis that there is no difference in patient-reported and objective outcomes of revision ligament reconstruction and tendon interposition (LRTI) compared with primary LRTI. METHODS: This case-control investigation enrolled 10 patients who had undergone revision LRTI at a tertiary care center. All patients had previously undergone primary trapeziectomy with LRTI. Patients with a minimum of 2 years' follow-up were eligible. All patients completed an in-office study evaluation...
December 2016: Journal of Hand Surgery
T Lögters, S Gehrmann, J Windolf
In patients with carpometacarpal osteoarthritis of the thumb, treatment strategies should be based on functional impairment and pain. Although X‑ray imaging is an integral component of the diagnostics, it is of subordinate importance for the therapy algorithm. Conservative therapy is always the first step in the chain of treatment. The efficacy of non-operative treatment, including intermittent immobilization using splinting and the application of technical assist devices in the daily routine has been proven to achieve pain relief...
December 2016: Der Unfallchirurg
B J Braun, N T Veith, F S Frueh, M Klein, W Knopp, T Pohlemann
PURPOSE: This study analyses our results after revision surgery for failed trapezectomy and suspension arthroplasty with painful proximalisation of the 1(st) metacarpal using the Mini TightRope(®). PATIENTS AND METHODS: In a prospective observational study, 5 patients (4 women and 1 man) with an average age of 62 years were treated with the Mini TightRope(®) for revision of a failed Epping arthroplasty with painful proximalisation of the first ray. The mean time between initial surgery and revision was 23...
August 2016: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Kim R Spekreijse, Ruud W Selles, Muhammed A Kedilioglu, Harm P Slijper, Reinier Feitz, Steven E Hovius, Guus M Vermeulen
PURPOSE: To compare the long-term outcomes of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) with trapeziometacarpal arthrodesis for osteoarthritis (OA) of the basal thumb joint. METHODS: Patients were evaluated for pain, daily functioning, strength, and complications after a mean follow-up of 5.3 years. Generalized estimating equations statistics were used to compare repeated measurements over time in both groups. RESULTS: After 5 years, patients who had trapeziectomy with LRTI had significantly better pain reduction and function than the arthrodesis group...
September 2016: Journal of Hand Surgery
Massimo Corain, Nicola Zampieri, Raffaele Mugnai, Roberto Adani
BACKGROUND: Various surgical techniques were reported with excellent result for the treatment of trapeziometacarpal joint arthritis. However, the best treatment option was not defined yet. METHODS: This randomized prospective study compared the result of two surgical techniques: tendon interposition arthroplasty (64 patients) and K. wire distraction (56 patients) after trapeziectomy for stage 3 or 4 osteoarthritis of the trapeziometacarpal joint. RESULTS: After a mean follow-up period of 6...
February 2016: Journal of Hand Surgery Asian-Pacific Volume
Aparajit Naram, Keith Lyons, Douglas M Rothkopf, Edward R Calkins, Thomas Breen, Marci Jones, John V Shufflebarger
BACKGROUND: In the treatment of basal joint arthritis of the thumb, recent studies suggest equivalent outcomes with regard to long-term pain, mobility, and strength, in patients undergoing either trapeziectomy alone or trapeziectomy with ligament reconstruction and tendon interposition (LRTI). The goal of this study was to investigate risk factors for complications in carpometacarpal (CMC) arthroplasty. METHODS: We conducted a retrospective chart review of 5 surgeons at a single institution performing CMC arthroplasties from November 2006 to November 2012...
March 2016: Hand: Official Journal of the American Association for Hand Surgery
Genevieve Landes, Michael P Gaspar, Peter Goljan, Sidney M Jacoby, Abdo Bachoura, Randall W Culp
BACKGROUND: Arthroscopic trapeziectomy with suture button suspensionplasty (ATBS) is a relatively new surgical option for the treatment of thumb carpometacarpal (CMC) osteoarthritis. Although ATBS has many potential benefits over alternative surgical treatments for CMC arthritis, little data exist regarding its safety and complication rates. The purpose of this study was to demonstrate that ATBS is associated with a low risk of complications within 1 year of surgery. METHODS: A retrospective review of patients treated with ATBS by one senior hand surgeon over a span of 3 years was performed...
June 2016: Hand: Official Journal of the American Association for Hand Surgery
J van Aaken, N Holzer, L Wehrli, F Delaquaize, I A Gonzalez, J Y Beaulieu
: The PI2® spacer is designed for treatment of trapeziometacarpal (TM) osteoarthritis. However, the shape of this implant has raised concerns about its stability. We retrospectively investigated 45 implants in 41 patients treated for trapeziometacarpal osteoarthritis in our hospital between 2004 and 2009 who underwent trapeziectomy and insertion of a PI2® spacer. Outcome parameters included revision rates and clinical outcomes correlated with implant position and scaphometacarpal distance, assessed using standard radiographs...
June 8, 2016: Journal of Hand Surgery, European Volume
Elham Mahmoudi, Frank Yuan, Meghan E Lark, Oluseyi Aliu, Kevin C Chung
BACKGROUND: Despite equivalent outcomes among surgical treatments of thumb carpometacarpal arthritis, little is known about the variation in spending. Because of its complexities, the authors hypothesized that trapeziectomy with ligament reconstruction and tendon interposition incurs the greatest cost to Medicare compared with other surgical procedures. METHODS: Using a random 5 percent sample of Medicare beneficiaries diagnosed with thumb carpometacarpal joint arthritis, the authors examined total and out-of-pocket spending for 3530 patients who underwent a surgical treatment between 2001 and 2010...
June 2016: Plastic and Reconstructive Surgery
Panagiotis Givissis, Nikolaos Platon Sachinis, Panagiotis Akritopoulos, Stavros I Stavridis, Anastasios Christodoulou
PURPOSE: Arthritis of the carpometacarpal joint of the thumb is common, and there are many studies regarding its treatment. We investigated the long-term outcome of interposition arthroplasty with a fascia lata allograft (pillow technique), without ligament reconstruction, to treat thumb carpometacarpal arthritis. The technique consisted of complete trapeziectomy, use of alloplastic tensor fascia lata, and K-wire immobilization for 5 weeks. METHODS: The outcomes of 31 thumbs in 24 female patients were measured at a mean follow-up of 12...
July 2016: Journal of Hand Surgery
Carl M Harper, Matthew L Iorio
Thumb web space contracture following hand trauma can be disabling with numerous reconstructive procedures existing to correct the resultant deformity. Following marked soft tissue injury to the hand we utilized the Stryker Hoffmann II Micro External Fixator System to link the first and second metacarpals by a multiplanar system using 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods. This facilitated placement of the thumb in maximal palmar abduction as well as allowed adjustment of thumb position throughout the postoperative period...
September 2016: Techniques in Hand & Upper Extremity Surgery
Jean-David Werthel, Thierry Dubert
UNLABELLED: Recent studies seem to show that ligament reconstruction with tendon interposition (LRTI) does not provide any benefit over trapezium excision alone; however dorsal subluxation was not measured in these studies. We believe it is logical to perform ligamentoplasty in order to obtain long-term stability and therefore treat dorsal subluxation. Our aim is to verify this hypothesis in an observational prospective study of LRTI using the entire flexor carpi radialis (FCR) tendon...
April 2016: Hand Surgery and Rehabilitation
Philippe Willekens, Koenraad Verstraete, Nadine Hollevoet
The purpose of this study was to evaluate patients who were treated with trapeziectomy and Dacron interposition in our hospital and to describe the incidence of foreign body reactions. Between 2004 and 2010, 10 women with trapeziometacarpal osteoarthritis underwent Dacron interpositional arthroplasty. One patient had surgery in both hands. Implants were removed in two patients, 5 and 8 years postoperatively. Histological analysis confirmed the presence of a foreign body reaction with giant cells in both cases...
February 2016: Hand Surgery and Rehabilitation
H Lenoir, A Erbland, D Lumens, B Coulet, M Chammas
Total trapeziometacarpal (TMC) joint replacement is increasingly being performed for the treatment of basal joint arthritis. However, complications such as instability or loosening are also frequent with TMC ball-and-socket joint replacement. Management of these complications lacks consensus. The purpose of this study was to report the results of 12 cases of failed TMC joint replacement that were treated by trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. The follow-up consisted of functional (numerical scale, DASH score, satisfaction), physical (range of motion, strength) and radiological (Barron and Eaton ratio measurement) assessments...
February 2016: Hand Surgery and Rehabilitation
Mani Seetharaman, Mark A Vitale, Kapil Desai, John F Crowe
Background Arthritis of the first carpometacarpal (CMC) joint has been surgically treated in multiple ways with varying levels of success as measured by subjective and objective measures. Trapeziectomy with numerous variations in suspensionplasty comprises one of the more commonly used surgical procedures. Recently, the Mini TightRope apparatus has been utilized as a new method for achieving suspensionplasty, and as such lacks significant review of use and safety in the literature. Case Description An extensor pollicis longus (EPL) rupture following a trapeziectomy and Mini TightRope suspensionplasty for CMC arthritis of the thumb is presented...
May 2016: Journal of Wrist Surgery
Anne J Spaans, L Paul van Minnen, Marieke E Weijns, Assa Braakenburg, Aebele B Mink van der Molen
Background Many surgical treatment options for osteoarthritis (OA) of the trapeziometacarpal (TMC) joint exist. However, no procedure has been proven superior. Good results have been described for TMC joint replacement. Purpose To analyze the results of the Ivory prosthesis in the treatment of symptomatic TMC OA. Patients and Methods A retrospective single-center follow-up study was performed. Visual analogue scale (VAS) for pain, Disabilities of the Arm, Shoulder and Hand (DASH) score, Michigan Hand Outcomes Questionnaire (MHQ), active range of motion, strength, and radiological outcomes were assessed and analyzed...
May 2016: Journal of Wrist Surgery
Naoki Kato, Keizo Fukumoto
It is well known that treatment of the old fracture-dislocations of the fifth carpometacarpal (CMC) joint is challenging. For patients with persistent pain due to this condition, numerous surgical techniques have been proposed. Here, we present a novel surgical technique, CMC joint suspension arthroplasty, using a partial slip of the extensor carpi ulnaris tendon. This procedure follows principles similar to the procedure of trapeziectomy with suspension arthroplasty for treatment of thumb CMC joint arthritis...
June 2016: Techniques in Hand & Upper Extremity Surgery
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