Document Detail


Outcomes of trapeziectomy with a modified abductor pollicis longus suspension arthroplasty for the treatment of thumb carpometacarpal joint osteoarthritis.
MedLine Citation:
PMID:  18626369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Various arthroplasty procedures have been described for the treatment of thumb carpometacarpal joint osteoarthritis. The purpose of this study was to determine the outcomes of patients treated with trapeziectomy and a variation of abductor pollicis longus suspension arthroplasty.
METHODS: Eighteen consecutive patients were treated by a single surgeon (K.C.C.) with trapeziectomy and abductor pollicis longus suspension arthroplasty (21 thumbs). Prospective outcomes data were collected before the operation and at 3, 6, and 12 months after surgery. Outcomes were assessed with x-rays, grip/key pinch strength, the Jebsen-Taylor test, and the Michigan Hand Outcomes Questionnaire.
RESULTS: Immediately after surgery, a 32 percent loss in carpometacarpal joint height was observed and an additional 11 percent proximal metacarpal migration was observed at 1 year. The mean grip strength was 11.1 kg preoperatively and 7.7, 14.3, and 16.7 kg at 3 months, 6 months, and 1 year postoperatively, respectively. Michigan Hand Outcomes Questionnaire results demonstrated improvements in all domains. Statistically significant improvements were noted in the domains of overall score, from 41 to 67 (p = 0.03); activities of daily living, from 43 to 66 (p = 0.01); work, from 41 to 65 (p = 0.05); patient satisfaction, from 25 to 68 (p = 0.01); and pain, which decreased from 73 to 30 (p < 0.01).
CONCLUSIONS: Abductor pollicis longus suspension arthroplasty is a faster and technically easier technique that avoids any additional deficit by using an accessory tendon. This procedure gives acceptable patient-rated outcomes, especially in pain relief and satisfaction.
Authors:
Edwin Y Chang; Kevin C Chung
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  122     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-16     Revised Date:  2011-02-16    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  505-15     Citation Subset:  AIM; IM    
Affiliation:
Section of Plastic Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, Mich 48109-0340, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthroplasty / methods*
Carpometacarpal Joints / surgery*
Disability Evaluation
Female
Hand Strength / physiology
Humans
Male
Middle Aged
Osteoarthritis / surgery*
Patient Satisfaction
Postoperative Complications / etiology*,  physiopathology,  surgery
Prospective Studies
Reoperation
Tendons / surgery*
Thumb / surgery*
Trapezium Bone / surgery*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K24 AR053120-04/AR/NIAMS NIH HHS; K24AR053120/AR/NIAMS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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