[The operative treatment of rhizarthrosis for patients with extreme exposure of the hand by athletic activities--is the trapeziectomy with interposition of an pyrocarbon spacer a option for treatment?].
OBJECTIVE
The rhizarthrosis is the most common degenerative joint disease of the hand. Incidence is detected around 10 %. For the treatment of rhizarthrosis different conservative and surgical methods are available. As many publications deal with the outcome of different surgical procedures. However there are no experiences in possibility of resuming an extreme exposure of the hand by athletic activities and the relevant timeframe between surgical treatment and the resumption as well as which of the competing surgical procedures you should suggest the patient.


METHODS
A female 46-year-old tennis player went to hospital in January 2005 with rhizarthrosis in stage 3 according to Eaton of the dominant right hand with pain during rest and exertion in the right basal joint. She was treated with trapeziectomy and interposition of a pyrocarbon spacer. Since the last clinical and radiological check in spring 2009, the patient is completely free of complaints and has resumed to play tennis 1 - 2 hours per day at tournament level. The correct position of the pyrocarbon spacer is radiologically verified while the joint space in the carpo-metacarpal joint is constant.


CONCLUSIONS
The trapeziectomy with interposition of an pyrocarbonspacer is a worthfull alternative compared to other established operative techniques. The demonstrated casuistic proves that this treatment matches both the high and multiaxial stress on the first ray of athletes. Four dislocations in the examined collective and the price of the implant of 930 Euro has to be discussed critically.
Szalay
G
G
Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Giessen. Gabor.Szalay@chiru.med.unigiessen.de
Meyer
C
C
Jürgensen
I
I
Stigler
B
B
Schnettler
R
R
D002244:Carbon; D012090:Cumulative Trauma Disorders / Q000601:surgery*; D006230:Hand Injuries / Q000601:surgery*; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D019736:Prostheses and Implants; D013715:Tennis / Q000293:injuries*; D051222:Trapezium Bone / Q000601:surgery*; D016896:Treatment Outcome
D002244:Carbon