title: A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis.
abstract: We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2-6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis.
  
  
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authors.affiliation: Istituto Ortopedico Galeazzi IRCCS, Milano, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rubino
authors.affiliation: Clinica Ortopedica dell'Università degli Studi di Genova, Genova, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Cavagnaro
authors.affiliation: Orthopaedic Department of the Università degli Studi di Milano, Istituto Ortopedico Galeazzi IRCCS, Milano, Italy valerio.sansone@unimi.it.
authors.forename: V
authors.initials: V
authors.lastname: Sansone
mesh_terms: D000368:Aged; D001178:Arthroplasty / Q000379:methods*; D050824:Carpal Joints; D052737:Carpometacarpal Joints; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011542:Pseudarthrosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: Thumb; arthroplasty; osteoarthritis; pseudoarthrosis; scaphotrapezial joint; trapeziometacarpal