ARTHROSCOPIC PARTIAL TRAPEZIECTOMY AND TIGHT-ROPE SUSPENSIONPLASTY IN THE TREATMENT OF FIRST CARPOMETACARPAL JOINT EATON-LITTLER STAGE 2-3 ARTHROSIS
?smail Bülent Özçelik, Ass. Prof.; IST-EL Hand Surgery, Microsurgery and Rehabilitation Group, ?stanbul, Turkey; Meriç U?urlar, MD; Sisli Hamidiye Etfal Training and Research Hospital, ?stanbul, Turkey; Abdulkadir Sar?, MD; Nam?k Kemal University School of Medicine, Tekirda?, Turkey; Remzi Tack?n Ozalp, Prof. Dr.; Cemal Bayar University, Manisa, Turkey; Mehmet Armangil, Assoc. Prof.Dr; Ankara Universitesi, Ankara, Turkey
Degenerative arthritis of the first carpometacarpal (CMC) joint is the most common degenerative condition in the hand that affects the activities of daily living and many different surgical procedures has been applied for years. However, in the studies there is no consensus about the superiority of one technique to another. In this study, we evaluated the early results of the patients with first CMC Eaton-Littler stage 2-3 arthrosis, who are operated to prevent first metacarpal joint subluxation and migration with tight-rope after arthroscopic joint debridement.
Between 2012-2014 twenty-one patients (16 female, 5 male) were evaluated retrospectively. Mean age was 52.3 (range: 40-60) years. The preoperative and postoperative assessment was performed with VAS and DASH. The preoperative and postoperative first CMC joint hyperextension and flexion movements were evaluated. The preoperative and postoperative grip strength, appositional and oppositional forces were measured with jamar hand dynamometer and lateral, two-point, and three-point pinch were measured with jamar hydraulic pinch gauge.
Mean follow-up period was 50.1 (range: 48-60) months. The patients were assessed after arthroscopy according to Badia classification. The VAS values were 8.2 preoperatively and 1.9 postoperatively. Preoperative DASH values were 23.4 and the postoperative DASH values were 5.5. Preoperative mean grip strength was 16.1 kg and postoperative mean grip strength was 27.6 kg.
It is observed in the early results that arthroscopic debridement and tight-rope controlling the lateral subluxation and instability with joint distraction provides pain relief with a functional hand.
Type of study/ Level of evidence: Therapeutic III.
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