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      Arthroscopic partial trapeziectomy and tendon interposition for thumb carpometacarpal arthritis

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          Abstract

          Background

          The purpose of this study was to introduce arthroscopic partial trapeziectomy and tendon interposition for the treatment of symptomatic thumb carpometacarpal arthritis of Eaton stage II or III.

          Methods

          From August 2001 to April 2009, 23 patients with thumb carpometacarpal arthritis were treated using this technique. Pain score, range of motion, and pinch strength were clinically evaluated and compared with the preoperative values after a minimum follow-up duration of 24 months.

          Results

          Significant reduction in pain score and increases in range of motion and pinch strength were found (all p < 0.001) after a 2-year follow-up. The mean ± SD (median) postoperative pain score was 1.0 ± 0.7 (1.0) at rest and 1.3 ± 0.9 (1.0) during daily activities. The postoperative range of motion was 19.1° ± 4.2° (20°) for extension and 35.7° ± 7.1° (35.0°) for flexion, and the postoperative pinch strength was 86.5 % ± 19.9 % (90.0 %). No complications were observed in our patient series.

          Conclusions

          Arthroscopic partial trapeziectomy and soft tissue interposition could be an alternative treatment method for patients with symptomatic thumb carpometacarpal arthritis of Eaton stage II or III.

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          Most cited references29

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          Management of osteoarthrosis of the thumb joints.

          We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis. Surgical treatment for interphalangeal arthritis is mainly arthrodesis.
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            To suspend or not to suspend: a randomised single blind trial of simple trapeziectomy versus trapeziectomy and flexor carpi radialis suspension.

            The thumb carpometacarpal joint is the second most common site of osteoarthritis in humans. There are numerous operations for the condition but, perhaps, the commonest is trapeziectomy, sometimes supplemented by a suspension procedure, most commonly using part of the flexor carpi radialis tendon. In order to determine whether there is an advantage to a suspension procedure, or not, 65 patients with Eaton and Glickel Grade III or IV arthritis of the carpometacarpal joint of their thumbs were randomised into either undergoing trapeziectomy alone (with no wiring) or a trapeziectomy with flexor carpi radialis suspension. Patient satisfaction from both operations was similar. There was increased range of movement in the trapeziectomy alone group, but there was no difference in grip or pinch strength. Measurement of the gap on X-ray left by the trapeziectomy was less when trapeziectomy alone was performed.
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              Hypermobility associated with osteoarthritis of the thumb base: a clinical and radiological subset of hand osteoarthritis.

              To study the impact of articular hypermobility on the clinical and radiological features of hand osteoarthritis (OA) and to investigate whether hand osteoarthritis associated with hypermobility should be considered a separate subset of hand OA. Fifty consecutive female patients with clinical hand OA and thumb base symptoms were examined for hypermobility according to the Beighton criteria. Thirty one of the 50 patients had hypermobility features (Beighton score > or = 2) and 17 patients fulfilled four or more Beighton criteria. Corresponding figures for 94 control patients were 30 (p or = 90 degrees is useful in identifying most patients with hand OA and hypermobility.
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                Author and article information

                Contributors
                yungchanglu@hotmail.com
                jui_tien_shih@hotmail.com
                Journal
                J Orthop Surg Res
                J Orthop Surg Res
                Journal of Orthopaedic Surgery and Research
                BioMed Central (London )
                1749-799X
                18 December 2015
                18 December 2015
                2015
                : 10
                : 184
                Affiliations
                [ ]Department of Orthopaedic Surgery, MacKay Memorial Hospital, No. 92 Sec. 2 Zhongshan N. Rd., Taipei City, Taiwan
                [ ]Department of Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan
                [ ]Department of Dentistry, National Yang-Ming University, No. 155 Sec. 2 Linong St, Taipei City, Taiwan
                [ ]Department of Cosmetic Application and Management, MacKay Junior College of Medicine, Nursing, and Management, No. 92 Shengjing Rd, Taipei City, Taiwan
                [ ]Department of Orthopaedic Surgery, Taoyuan Armed Forces General Hospital, No. 168 Zhongxing Rd, Longtan District Taoyuan City, Taiwan
                Article
                329
                10.1186/s13018-015-0329-y
                4683864
                26684740
                0912074b-3cb1-4765-a82d-c52b30064bec
                © Chuang et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 May 2015
                : 30 November 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Surgery
                thumb carpometacarpal joint,arthroscopic,arthritis,trapeziectomy,level of evidence: level iv

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