Trapeziometacarpal(TMC) joint is the secondly affected joint for osteoarthritis in the hand.TMC joint arthritis affects most commonly postmenopausal women after the fifth decade of life,due to hormonal and structural ...Trapeziometacarpal(TMC) joint is the secondly affected joint for osteoarthritis in the hand.TMC joint arthritis affects most commonly postmenopausal women after the fifth decade of life,due to hormonal and structural factors.Rhizarthrosis may lead to a clinical spectrum from subtle symptoms to advanced symptoms such as;severe pain,limitation of range of motion,muscular weakness,bony deformities,and end up ultimately with disability.Regardless of the etiopathogenesis;a variety of non-surgical and surgical methods have been used for the treatment of rhizarthrosis,depending on the age of the patient,symptomatology and the stage of the disease.The main goals of the treatments are as follows;relief of pain,conservation or restoration the stability and mobility of the TMC joint with the optimal preservation of the strength of surrounding musculature.In this article,the current methods,which have been used for the treatment of TMC joint osteoarthritis,will be mainly reviewed,together with concise up-to-date information on both its diagnosis and the anatomy of the TMC joint.展开更多
BACKGROUND Basal joint arthritis is a common disease which is especially present in postmenopausal women. A variety of procedures have been described once conservative treatment has failed. The purpose of our study is...BACKGROUND Basal joint arthritis is a common disease which is especially present in postmenopausal women. A variety of procedures have been described once conservative treatment has failed. The purpose of our study is to present a novel surgical technique based on a clinical case with three-year follow-up which is highly effective, even after failure of previous procedures. CASE SUMMARY We present a case of a 39 year-old-woman who suffered from recurring, persistent, sharp left thumb pain for several years After two operative procedures, she presented again with intolerable, sharp pain over the trapeziometacarpal joint, and wished to proceed with a pain relieving procedure or arthroplasty. Intraoperatively, the articular surfaces appeared well, without any bare areas of bone or eburnation, resulting in the decision to perform a “subtraction hemiarthroplasty”. A shortening osteotomy of the os trapezium was performed by removing a slice of 8-9 mm bone, without damaging the joint cartilages. The osteotomy was stabilized using two screws, the ligament and capsular tissue was suture imbricated, and a cut down on the translation and a dorsal radial ligament reconstruction were performed. Three years after the final procedure, a long-term follow-up demonstrates excellent results, pain free with full range-of-motion. CONCLUSION Subtraction hemiarthroplasty with ligament tightening imbrication and reconstruction of the radial ligament led to excellent results in motion and pain.展开更多
文摘Trapeziometacarpal(TMC) joint is the secondly affected joint for osteoarthritis in the hand.TMC joint arthritis affects most commonly postmenopausal women after the fifth decade of life,due to hormonal and structural factors.Rhizarthrosis may lead to a clinical spectrum from subtle symptoms to advanced symptoms such as;severe pain,limitation of range of motion,muscular weakness,bony deformities,and end up ultimately with disability.Regardless of the etiopathogenesis;a variety of non-surgical and surgical methods have been used for the treatment of rhizarthrosis,depending on the age of the patient,symptomatology and the stage of the disease.The main goals of the treatments are as follows;relief of pain,conservation or restoration the stability and mobility of the TMC joint with the optimal preservation of the strength of surrounding musculature.In this article,the current methods,which have been used for the treatment of TMC joint osteoarthritis,will be mainly reviewed,together with concise up-to-date information on both its diagnosis and the anatomy of the TMC joint.
文摘BACKGROUND Basal joint arthritis is a common disease which is especially present in postmenopausal women. A variety of procedures have been described once conservative treatment has failed. The purpose of our study is to present a novel surgical technique based on a clinical case with three-year follow-up which is highly effective, even after failure of previous procedures. CASE SUMMARY We present a case of a 39 year-old-woman who suffered from recurring, persistent, sharp left thumb pain for several years After two operative procedures, she presented again with intolerable, sharp pain over the trapeziometacarpal joint, and wished to proceed with a pain relieving procedure or arthroplasty. Intraoperatively, the articular surfaces appeared well, without any bare areas of bone or eburnation, resulting in the decision to perform a “subtraction hemiarthroplasty”. A shortening osteotomy of the os trapezium was performed by removing a slice of 8-9 mm bone, without damaging the joint cartilages. The osteotomy was stabilized using two screws, the ligament and capsular tissue was suture imbricated, and a cut down on the translation and a dorsal radial ligament reconstruction were performed. Three years after the final procedure, a long-term follow-up demonstrates excellent results, pain free with full range-of-motion. CONCLUSION Subtraction hemiarthroplasty with ligament tightening imbrication and reconstruction of the radial ligament led to excellent results in motion and pain.
