title: Modified metacarpal shortening osteotomy of the midcarpal bone for preserving metacarpophalangeal joints in patients with rheumatoid arthritis.
abstract: Recent advances in medication choices have strikingly improved the management of rheumatoid arthritis. However, medication alone cannot place back already deformed joints. Thus, to prevent metacarpophalangeal (MP) joint destruction, joint deformity correction should be considered since mechanical stress induced by finger motions will eventually destruct the undestructed joint, with a possibility of recurrence and future implant arthroplasty in mind since RA still remains as a progressive disease. We report a modified metacarpal shortening osteotomy for correcting MP joint deformity. The advantage of our technique over previous osteotomies is that it easily allows for subsequent implant arthroplasty even after the recurrence of joint deformity/destruction. Major modifications include that the metacarpal is shortened at its mid-shaft and the osteotomy is performed vertical to the shaft and fixed with surgical wiring. We believe that combination therapy consisting of medication and surgery is preferable to prevent joint destruction, even in this age of biological agents.
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.|b Department of Orthopaedic Surgery , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ochi
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sakuma
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishida
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yano
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Takuma
authors.initials: T
authors.lastname: Koyama
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Mina
authors.initials: M
authors.lastname: Ishibashi
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.affiliation: a Department of Orthopaedic Surgery , Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan and.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
mesh_terms: D001172:Arthritis, Rheumatoid / Q000601:surgery*; D006801:Humans; D050279:Metacarpal Bones / Q000601:surgery*; D008662:Metacarpophalangeal Joint / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D019736:Prostheses and Implants
keywords: Metacarpophalangeal joints; Midcarpal; Osteotomy; Rheumatoid arthritis; Shaft; Shortening osteotomy