Abstract

GARCIA-BERNAL, Francisco-Javier. Surgical management of the thumb arthritis: asessment of outcomes of different techniques. Cir. plást. iberolatinoam. [online]. 2017, vol.43, suppl.1, pp.s55-s62. ISSN 1989-2055.

Background and Objective. Osteoarthritis of the thumb carpometacarpal (CMC) joint remains one of the main reasons for visiting a Hand Centre. Whenever the conservative treatment fails, the surgical approach will be offered. This treatment should be indicated individually for each patient, depending on various factors as the age, the degeneration degree, the functional demand and so on. In this paper the author analyse the outcomes of different techniques, based on his own surgical experience. Methods. Between April 2011 and February 2015, 97 cases of thumb arthritis have been treated surgically. The average age of the patients was 54.01 years, with predominance of females (85.5 %). The most frequently used technique was the ligament reconstruction tendon interposition technique, as Weilby's recomends with 79 cases. In 9 cases an arthroscopic arthroplasty was performed (ATK); in 4 patients a CMC fusion; and in 5 a ligamentoplasty. Results. Out of the 97 patients, 49 have been controlled with an average follow up of 18.3 months. Patients referred an improvement in pinch strength of 24.28% in the Weilby's technique group; 18.74% in the ATK group; 45.75 % in the CMC fusion group; and 31.42 % in the ligamentoplasty group. Focus on the pain, assessed by the visual analog scale, the improvement was 5.50, 5.1, 6.34 and 6.33 points respectively, compared to the preoperative situation. Conclusions. These outcomes confirm the usefulness of the suspension - interposition arthroplasty as an ideal technique for the common patient of rizarthrosis. In some cases, some factors such as age, functional demand or the degree of joint degeneration, lead us to look for other techniques in order to satisfy needs patient's request.

Keywords : Thumb osteoarthritis; Arthroplasty; Arthroscopy; Hand.

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