title: [Chronic instability of the metacarpophalangeal joint of the thumb without arthrosis. Apropos of 16 cases].
abstract: A series of 16 cases of chronic instability of the metacarpo-phalangeal joint of the thumb is presented. The authors begin by summarising the two main surgical procedures used in such cases: ligamentous reconstruction and arthrodesis. In our series, a ligamentous reconstruction with Smith's procedure was performed in 13 patients, a primary arthrodesis in 2 patients and a secondary suture in one patient. The results are analysed in 15 patients (7 women, 8 men) with a minimum followup time of two years. Failure was noted in 4 cases treated by ligamentous reconstruction (3 men and 1 woman). An arthrodesis was subsequently performed in all these patients. There were therefore a total of 6 arthrodesis and 8 ligamentous reconstruction to review. Ligamentous reconstruction gave better functional results than arthrodesis in particular as regards mobility, opposition of the thumb and strength of pinch grip (decreased by 50% with arthrodesis). In manual workers the use of ligamentous reconstruction in these cases was shown in our series to give inconstant results.
authors.affiliation: Service d'Orthopédie-Traumatologie, Besançon.
authors.forename: Y
authors.initials: Y
authors.lastname: Tropet
authors.forename: J M
authors.initials: JM
authors.lastname: Brientini
authors.forename: D
authors.initials: D
authors.lastname: Menez
authors.forename: P
authors.initials: P
authors.lastname: Vichard
mesh_terms: D000328:Adult; D001174:Arthrodesis / Q000379:methods; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008662:Metacarpophalangeal Joint / Q000502:physiology / Q000601:surgery*; D009068:Movement; D013314:Stress, Mechanical; D013933:Thumb / Q000293:injuries / Q000502:physiology / Q000601:surgery*
vernacular_title: Instabilité chronique de l'articulation métacarpo-phalangienne du pouce sans arthrose. A propos de seize observations.