title: Surgical Technique and Clinical Results for Trapeziometacarpal Arthrodesis Using Locking Plate Fixation in Women Aged 50 Years or Older.
abstract: BACKGROUND
  The authors hypothesized that locking plates have the potential to decrease the risk of nonunion for trapeziometacarpal joint arthrodesis and eliminate the period of postoperative immobilization. The surgical technique is described and the clinical results are reported for Eaton stage III trapeziometacarpal joint arthrodesis using locking plate fixation in elderly women.
  
  
  METHODS
  The outcomes of 18 fusion operations with a 2-year follow-up were assessed during this prospective study. Patients were evaluated for bone union, grip strength, tip and key pinch strength, and Kapandji opposition scores. The Disabilities of the Arm, Shoulder and Hand questionnaire and visual analogue scale pain scores were obtained from the patients and evaluated. In addition, complications were assessed.
  
  
  RESULTS
  Bone unions were obtained for 16 of 18 fusions. Grip strength was 18.3 kg (range, 12.5 to 26.0 kg), tip pinch strength was 5.6 kg (range, 3.5 to 7.5 kg), and key pinch strength was 6.4 kg (range, 4.0 to 7.5 kg). The Kapandji opposition score was 8.3 points (range, 8 to 10). Disabilities of the Arm, Shoulder and Hand questionnaire score decreased from 54.2 (range, 68.8 to 39.4) to 8.8 (range, 3.9 to 22.0), and visual analogue scale pain scores decreased from 8.3 (range, 8 to 10) preoperatively to 0.9 (range, 0 to 4) postoperatively. Malpositioned devices were removed from two patients. One symptomatic patient required removal of the fixation device as a result of hardware loosening.
  
  
  CONCLUSIONS
  The results for arthrodesis with a locking plate are comparable to results with a nonlocking plate and are quite satisfactory in the appropriate hands.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: Chiba, Japan From the Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Abe
authors.forename: Susumu
authors.initials: S
authors.lastname: Tokunaga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001860:Bone Plates; D052737:Carpometacarpal Joints / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome