[Does Epping resection arthroplasty lead to loss of hand strength? A prospective study].
FCR-sling resectional arthroplasty does not definitely prevent a proximalisation of the first metacarpal bone. Since power transmission of the thenar muscles requires a particular length of the thumb, does proximalisation lead to a reduction of grip strength of the hand? In a prospective study, hand-, key- and pinch-grip strength was compared to preoperative data. Pain intensity and thumb mobility were also examined. In comparison to preoperative data, the pain-free pinch grip improved 60% after three months and 100% after 12 months (p < 0.01). The maximum pinch grip improved 11% after three and 34% after 12 months (p < 0.01). The pain-free key grip improved 22% after three months and 50% after 12 months (p < 0.01). The maximum key grip showed a fair reduction after three months, but after 12 months the key pinch strength came up to preoperative level. The hand grip strength showed a statistically significant improvement of 9% after three months and 34% after 12 months (p < 0.01). After one year, 80% of the patients were completely painfree. There was no clinically relevant disturbance of thumb movement following surgery. Owing to proximalisation of the first metacarpal, a scapho-metacarpal distance of 5.3 (2-9) mm was measured. Despite proximalisation of the first metacarpal, a significant improvement of the grip strength was observed, which was rooted in simultaneous pain reduction.
Krein
R
R
Abteilung für Hand-, Plastische und Wiederherstellungschirurgie, Malteser-Krankenhaus Bonn. krein@gmx.de
Richter
M
M
Brüser
P
P
D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000503:physiopathology*; D013933:Thumb / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome