[Jaccoud's arthropathy. Surgical results of 41 hands].
Jaccoud's arthropathy, which was first described in 1869, is a rare syndrome that is characterized by a painless or relatively painless deformity of the digits II, II, IV and V with a dislocation of the extensor tendons into the metacarpal valley. When the thumb is affected, a Z deformity is observed. The present analysis was based on 40 patients (56 hands, 41 of which were operated on over the period 1989 to 2001). A distinction should be made between Jaccoud's disease following a known inflammatory arthropathy (23 hands; average patient age 55 years) and the idiopathic form of the disease (18 hands, average patient age 70 years). From a clinical point of view, a classification of the deformities is needed so that appropriate surgical treatment can be determined. In the present study, four groups were therefore proposed, in groups I and III the realignment to centre of the extensor tendons of the metacarpophalangeal joint and joint stabilization yielded 83% positive results. In groups II and IV the results were only 66% good after Swanson implant. The pathogenesis of Jaccoud's disease has not yet been determined, but now that more information has become available and a better analysis can be made of its various clinical and anatomopathological charasteristics, these should assist in defining precise surgical indications.
Alnot
J Y
JY
Service de chirurgie de la main, hôpital Bichat, 46, rue Henri-Huchard, 75018 Paris cedex 18, France. jean-yves.alnot@bch.ap-hop-paris.fr
Liverneaux
P
P
Welby
F
F
D000368:Aged; D001174:Arthrodesis; D019643:Arthroplasty, Replacement; D006227:Hand Deformities, Acquired / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000601:surgery; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy; D019736:Prostheses and Implants; D013710:Tendons / Q000503:physiopathology* / Q000601:surgery*; D016896:Treatment Outcome