title: [Operative treatment of rhizarthritis: comparison of ligament reconstruction according to Epping with trapezectomy and interposition of pyrocarbon spacers as replacement of the trapezium].
abstract: BACKGROUND
  Rhizarthritis is the most common form of arthritis of the hand with a frequency of 10% and conservative as well as surgical methods of treatment are available. The aim of this study was to compare the results of resection suspension arthroplasty according to Epping with trapezium replacement using pyrocarbon spacers.
  
  
  METHODS
  Between January 2001 and December 2008 a total of 84 patients were surgically treated for rhizarthritis in our clinic. Of these patients 12 were treated with other surgical procedures, 40 with resection suspension arthroplasty according to Epping and 32 with pyrocarbon spacers as trapezium replacement. The patients were examined in a retrospective study and success of treatment was evaluated according to the Buck-Gramcko criteria.
  
  
  RESULTS
  According to the evaluation criteria over 80% of patients in both collectives achieved very good or good operative results with the same degree of satisfaction.
  
  
  CONCLUSIONS
  The results of this study confirm the value of resection suspension arthroplasty according to Epping for surgical treatment of rhizarthritis. Using trapezectomy with interposition of pyrocarbon spacers good or very good results can be achieved in the majority of cases. Essential points of criticism are the current material cost of 930 Euros and 4 dislocations in our collective but with good multiaxial movement and loading capacity. Comparable results using alternative procedures indicate that the results of further studies and long-term results will be decisive for establishment of this operational procedure.
authors.affiliation: Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Giessen und Marburg, Standort Giessen, Rudolf-Buchheim-Str. 7, D-35385, Giessen, Deutschland. Gabor.Szalay@chiru.med.uni-giessen.de
authors.forename: G
authors.initials: G
authors.lastname: Szalay
authors.forename: I
authors.initials: I
authors.lastname: Schleicher
authors.forename: V
authors.initials: V
authors.lastname: Alt
authors.forename: T
authors.initials: T
authors.lastname: Pavlidis
authors.forename: R
authors.initials: R
authors.lastname: Schnettler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery*; D018786:Bone Substitutes; D004047:Diethyl Pyrocarbonate / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008022:Ligaments / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000295:instrumentation / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D051222:Trapezium Bone / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D018786:Bone Substitutes; C079227:pyrocarbonic acid; D004047:Diethyl Pyrocarbonate