Osteotomy versus tendon arthroplasty in trapeziometacarpal arthrosis: 17 patients followed for 1 year.
We evaluated 2 consecutive cohorts of patients with primary trapeziometacarpal arthrosis 1 year after either first metacarpal osteotomy or trapezial excision with abductor pollicis longus tendon arthroplasty. At follow-up, 4 of 7 patients treated with osteotomy had pain at rest and/or with light activities and were dissatisfied with the results of surgery, all 4 had advanced (stage III) preoperative trapeziometacarpal arthrosis. 1 of 10 patients (5 having stage III arthrosis) treated with abductor pollicis longus arthroplasty had pain with light activities, and no patient was dissatisfied. Our findings indicate that first metacarpal osteotomy as a surgical option in trapeziometacarpal arthrosis should be limited to patients with early disease.
Hand Surgery Section, Department of Orthopedics, Hässleholm-Kristianstad Hospital, Kristianstad, Sweden. isam.atroshi@mailbox.swipnet.se
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Atroshi
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Axelsson
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Nilsson
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001178:Arthroplasty; D015331:Cohort Studies; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000601:surgery; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000628:therapy*; D010027:Osteotomy; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome; D014955:Wrist Joint / Q000601:surgery*