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Do trapeziometacarpal prosthesis provide better metacarpophalangeal stability than trapeziectomy and ligamentoplasty?
- Source :
- Orthopaedics and Traumatology-Surgery and Research, Orthopaedics and Traumatology-Surgery and Research, Elsevier, 2018, 104 (7), pp.1095-1100. ⟨10.1016/j.otsr.2018.07.008⟩
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Background No surgical management is better than another regarding functional recovery for trapeziometacarpal joint osteoarthritis. Metacarpophalangeal (MCP) hyperextension, directly due to the shortening of thumb height, appears to be a factor of poor prognosis. Hypothesis MCP hyperextension can be corrected by implantation of a trapeziometacarpal prosthesis (TMP), as opposed to trapeziectomy and ligamentoplasty (TL), and pinch strength is greater with TMP in this indication. Material and methods Sixty-nine patients (41 TMP and 28 TL) were retrospectively evaluated. The following were evaluated: pain, mobility of the metacarpophalangeal joints, palmar grip and pinch strength. Thumb height was measured on radiographs as a post/preoperative ratio. Results The mean follow-up was 20 months (6–38). The TMP group showed greater reduction of the metacarpophalangeal hyperextension in all hyperextension groups, especially hypertension >30°, compared with TL. The TMP group provided significant greater pinch strength in all the subgroups with preoperative MCP hyperextension. Patient with postoperative MCP hyperextension had a significant lower grip and pinch strength compared with patient without MCP hyperextension. Radiographic analysis showed that thumb height changes were related to the degree of preoperative hyperextension. Postoperatively, patients with postoperative MCP hyperextension had a significant lower thumb height than patient without MCP hyperextension. Discussion Metacarpophalangeal hyperextension appears to be a factor of poor prognosis for surgical treatment of trapeziometacarpal osteoarthritis when it is not managed. TMP provides better metacarpophalangeal stabilization by restoring thumb length and would avoid surgery on the metacarpophalangeal joint. TMP may be recommended in patients having symptomatic trapeziometacarpal joint osteoarthritis and MCP joint hyperextension. Level of evidence III, retrospective observational case control study.
- Subjects :
- Male
Rhizarthrosis
Joint Prosthesis
[SDV]Life Sciences [q-bio]
Radiography
medicine.medical_treatment
Hyperextension
Osteoarthritis
030230 surgery
Metacarpophalangeal Joint
Metacarpophalangeal
0302 clinical medicine
Musculoskeletal Pain
Pinch Strength
Orthopedics and Sports Medicine
Range of Motion, Articular
Trapeziometacarpal prosthesis
Pain Measurement
030222 orthopedics
Middle Aged
3. Good health
Trapezium Bone
medicine.anatomical_structure
[SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system
Ligaments, Articular
Female
Adult
medicine.medical_specialty
Trapeziometacarpal prothesis
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Thumb
Arthroplasty
03 medical and health sciences
medicine
Humans
Body Weights and Measures
Reduction (orthopedic surgery)
Aged
Retrospective Studies
Trapeziectomy
business.industry
Metacarpophalangeal joint
medicine.disease
Surgery
body regions
Case-Control Studies
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 18770568
- Volume :
- 104
- Database :
- OpenAIRE
- Journal :
- Orthopaedics & Traumatology: Surgery & Research
- Accession number :
- edsair.doi.dedup.....69df86e40c476031f79f78d302c7fea6