[Results of basal joint arthrosis treatment--comparison of Epping ligament reconstruction with trapeziectomy alone].
Objective of this study is to compare clinical and radiological results of two different methods of treatment for trapeziometacarpal osteoarthrosis of the thumb. Eighteen patients received operative treatment. An operation according to Epping was performed in eleven cases (collective I), while nine cases were treated with a trapeziectomy only (collective II). The mean follow-up of the first collective was 40 months and 15 months for the second one. The results of the two patient groups were subjected to statistical comparison in a retrospective study. This revealed no significant differences with regard to active range of motion, power, and subjective symptoms, classified according to the Buck-Gramcko score. With a mean of 49 points for the first and 50 points for the second collective, both achieved very good results. However, the mean operating time was significantly shorter in the patients treated with a trapeziectomy only, while the mean distance between the base of the first metacarpal bone and the scaphoid bone was significantly greater in this group. This is surely due to the shorter follow-up of the patients who underwent trapeziectomy only, since further proximalisation has to be expected. We were able to demonstrate that both methods yield equally good results, and hence the simpler technique of trapeziectomy alone should be given preference, at least in the standard situation of a patient, whose intermetacarpal ligaments offer sufficient stability after trapeziectomy.
Mentzel
M
M
Abteilung Unfallchirurgie, Hand- und Wiederherstellungschirurgie, Universität Ulm. martin.mentzel@medizin.uni-ulm.de
Ebinger
T
T
Heckmann
E
E
Merk
S E
SE
Kinzl
L
L
Wachter
N J
NJ
D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging / Q000601:surgery*; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D013933:Thumb / Q000000981:diagnostic imaging / Q000601:surgery*