title: [Salvage procedure for painful proximalisation of the 1st metacarpal after trapeziectomy using the Mini TightRope®].
abstract: OBJECTIVE
  This study analyses our results after revision surgery for failed trapezectomy and suspension arthroplasty with painful proximalisation of the 1(st) metacarpal using the Mini TightRope(®).
  
  
  METHODS
  In a prospective observational study, 5 patients (4 women and 1 man) with an average age of 62 years were treated with the Mini TightRope(®) for revision of a failed Epping arthroplasty with painful proximalisation of the first ray. The mean time between initial surgery and revision was 23.1 (12.5-31.5) months; the mean follow-up was 25±7.7 (12-32) months. The pain level (visual analogue scale - VAS), pinch grip, and qDASH score were evaluated preoperatively and postoperatively. In addition, the Conolly score was used postoperatively. Directly after surgery and at the last follow-up exam, the degree of proximalisation of the first metacarpal was measured radiologically.
  
  
  RESULTS
  At the last follow-up, there was significant mean pain relief during everyday stress, from 5.2 preoperatively to 1.6 (p<0.01) postoperatively, and a significant increase in pinch grip, from 0.5 kg to 3 kg (p<0.01). qDASH improved significantly, from 54 to 20 (p<0.001). The Conolly score showed 2 good and 3 fair results. Renewed proximalisation could not be entirely prevented, but was limited to an average of 2 mm.
  
  
  CONCLUSIONS
  Mini TightRope(®) revision surgery after failed trapezectomy and suspension arthroplasty showes good results with significant pain reduction and gain of function. Renewed proximalisation of the first ray cannot be completely avoided.
authors: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg.
authors: B J
authors: BJ
authors: Braun
authors: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg.
authors: N T
authors: NT
authors: Veith
authors: Institut für Klinisch-Experimentelle Chirurgie, Universität des Saarlandes, Homburg.
authors: F S
authors: FS
authors: Frueh
authors: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg.
authors: M
authors: M
authors: Klein
authors: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg.
authors: W
authors: W
authors: Knopp
authors: Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum des Saarlandes, Homburg.
authors: T
authors: T
authors: Pohlemann
mesh_terms: D001178:Arthroplasty; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D050279:Metacarpal Bones / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D011446:Prospective Studies; D051222:Trapezium Bone; D016896:Treatment Outcome