Arthroplasty for Fifth Carpometacarpal Joint Arthritis

Yang, Yong; Scheker, Luis R.; Kumar, Kannan Karuppiah

doi:10.1055/s-0035-1549291

Cited by 7 publications

(7 citation statements)

References 14 publications

(12 reference statements)

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“…We were able to show that the STPI implant meets these three objectives and that the clinical and radiological results on the medium-term are good; unlike HM arthrodesis, an effective technique to reduce painful phenomena, but that does not allow to recover the curve of the hand and the original mobility of the V ray, essential elements to the "strength hand" and the "sharpness hand", and this is due to the decrease in the length of M5 and the mobility of the HM joint. Yang, Bain and Meraghini's studies of Dubert's intervention appeared to provide good clinical results and restore the length of M5, but give M5 the 4 th ray mobility segment [7,9,22].…”

Section: Discussionmentioning

confidence: 97%

Pyrocarbon Arthroplasty: An Innovative Alternative for Advanced Post-Traumatic Hamatometacarpal Arthritis

Baumann¹,

Klein²,

Emmanuel³

et al. 2020

J Orthop Surg Tech

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Background: Post-traumatic arthritis of the hamatometacarpal complex (HMC) is a very rare disease and it occurs as an early secondary effect to undiagnosed or non-well treated fractures or fracture/dislocations of the 5 th metacarpal basis. It frequently occurs to young patients and manual workers requiring an important strength and hand mobility.Treatment is not consensual and ranges from medical management to intermetacarpal arthrodesis.We propose an alternative technique: A pyrocarbon arthroplasty. Hypothesis:The main objective was to assess the clinical and radiographical results of the pyrocarbon arthroplasty in the case of post-traumatic arthritis of the hamatometacarpal (HM) joint at a mean follow up of 20 months.Methods: Between 2014 and 2016, we reported the case of 4 patients suffering from a post-traumatic HM arthritis. The population include 4 men, the average age was 41-years-old (35-51). The dorsal approach procedure was performed, then a 2 mm resection of the hamate and the 5 th metacarpal basis was performed, implant sizes (STPI Tornier, initially used for scaphotrapeziotrapezoid arthritis) were tried before setting up the definitive component. During the last followup, we assessed the pain (VAS pain score), DASH score, average grip strength on both hands patients satisfaction, and return to work time. On AP X-rays and stress views, we were assessed luxations, subluxations or osteoarthritis signs.Results: With a mean follow-up of 20 months, the average VAS pain score was 2 (0-6), the average DASH was 8.75 (0-15) and the average grip strength was 69.75% (55-96) compared to the contralateral side.All patients declared to be satisfied or very satisfied by the surgical procedure and the average return-to-work time was 2 months.All patients were able to go back to their work without any professional reclassification.No patients declared to have had postoperative complications.Radiological examinations displayed a good position of the implant and no further evolution of carpometacarpal arthritis. Conclusion:Pyrocarbon implant in case of hamatometacarpal arthritis is an easy and safe procedure which offered promising results concerning satisfaction, functionality and hand strength in young and manual-workers patients. The sample is small and previous studies about surgical solution for this disease are too heterogeneous to compare the different procedures. Preliminary results are satisfying. It could be an option to consider for patients with an advanced disease of this joint.

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Section: Discussionmentioning

confidence: 97%

Pyrocarbon Arthroplasty: An Innovative Alternative for Advanced Post-Traumatic Hamatometacarpal Arthritis

Baumann¹,

Klein²,

Emmanuel³

et al. 2020

J Orthop Surg Tech

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“…Elimina la causa principal del dolor y mejora significativamente la fuerza de agarre. 21,22 Otras opciones de tratamiento quirúrgico incluyen la resección de la base del quinto metacarpiano con desbridamiento de la articulación CMC, artroplastia de interposición y artroplastia estabilizadora, 23 donde se reseca la base del quinto metacarpiano y se fusiona al cuarto. 24 Las debilidades de este estudio, incluye la recopilación de datos retrospectivos, el pequeño número de pacientes, la perdida de pacientes durante el seguimiento y la inexistencia de un protocolo de manejo en la institución.…”

Section: Discussionunclassified

“…Elimina la causa principal del dolor y mejora significativamente la fuerza de agarre. 21 22 Otras opciones de tratamiento quirúrgico incluyen la resección de la base del quinto metacarpiano con desbridamiento de la articulación CMC, artroplastia de interposición y artroplastia estabilizadora, 23 donde se reseca la base del quinto metacarpiano y se fusiona al cuarto. 24…”

Section: Discussionunclassified

“…It eliminates the primary cause of pain and significantly improves grip strength. 21 22 Other surgical treatment options include resection of the base of the fifth metacarpal with debridement of the CMC joint, interposition arthroplasty, and stabilizing arthroplasty 23 consisting of resection of the base of the fifth metacarpal and its fusion to the fourth metacarpal. 24…”

Section: Discussionmentioning

confidence: 99%

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Luxofractura Hamate Metacarpiana. Presentación de 4 Casos y Revisión de la Literatura

Andrade,

Castillo,

Hernández

2023

Revista Chilena de Ortopedia y Traumatología

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ResumenLas luxofracturas hamate metacarpianas abarcan una amplia gama de lesiones complejas, raras en su aparición; suelen originarse al golpear con el puño objetos sólidos o por accidentes de alta energía. Clínicamente, el paciente presenta dolor y aumento de volumen en el borde cubital proximal de la mano. El diagnóstico definitivo esta dado por imágenes, en primera instancia, radiografías en cuatro proyecciones: postero anterior, oblicua en 30 grados, 60 grados y lateral, las cuales muestran el desplazamiento y rasgos de fractura. Idealmente debe complementarse con tomografía computada. El tratamiento es quirúrgico en general. Si se logra reducción óptima de forma cerrada se puede fijar percutáneo, pero con bajo umbral para realizar reducción abierta fijándose con agujas de Kirschner, tornillos o placa con el fin de disminuir el riesgo de mal unión, artrosis postraumática y dolor crónico. Presentamos 4 casos de pacientes con esta patología, con un seguimiento de 38 meses en promedio, que se sometieron a tratamiento quirúrgico en el mismo centro, con excelentes resultados funcionales reflejados en un DASH promedio de 9 puntos. Mostramos, además, una síntesis de la evidencia disponible, para guiar el manejo de una lesión de baja frecuencia, pero de importante implicancia para el pronóstico funcional de la mano.

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“…L'utilisation de mini-plaque permet de bien stabiliser l'arthrodèse et de diminuer le délai d'immobilisation. Entre autre, cette technique conserve la mobilité du cinquième rayon par transfert à l'interligne carpo-métacarpien du 4 ème rayon obligatoirement indemne et dont la physiologie est très proche de celle du 5 ème rayon bien que son secteur de flexion extension soit plus faible de 50% [ 6 , 14 ]. Le diagnostic des fractures-luxations de la base du M5 doit être précoce avec une exploration systématique devant tout traumatisme centrée sur le 5 ème rayon en insistant sur des incidences radiologiques bien réussites de face et de profil strict de la main.…”

Section: Discussionunclassified

Arthrose post-traumatique carpo-métacarpienne du cinquième doigt traitée par arthroplastie stabilisée: à propos de deux cas et revue de la littérature

Zribi

Jemaa

et al. 2018

Pan Afr Med J

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Les fractures-luxations anciennes de la base du cinquième métacarpien peuvent se compliquer d'une arthrose post-traumatique gênante sur le plan fonctionnel et de prise en charge difficile. La technique d'arthroplastie stabilisée comporte une résection arthroplastique de la base du cinquième métacarpien associée à une arthrodèse diaphyso-métaphysaire latérale entre le quatrième et le cinquième métacarpien. A travers deux observations, nous présentons les objectifs de cette technique d'arthroplastie stabilisée et ses particularités par rapport aux autres techniques destinées au traitement des séquelles des fractures-luxations de la base du M5.

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Arthroplasty for Fifth Carpometacarpal Joint Arthritis

Cited by 7 publications

References 14 publications

Pyrocarbon Arthroplasty: An Innovative Alternative for Advanced Post-Traumatic Hamatometacarpal Arthritis

Pyrocarbon Arthroplasty: An Innovative Alternative for Advanced Post-Traumatic Hamatometacarpal Arthritis

Luxofractura Hamate Metacarpiana. Presentación de 4 Casos y Revisión de la Literatura

Arthrose post-traumatique carpo-métacarpienne du cinquième doigt traitée par arthroplastie stabilisée: à propos de deux cas et revue de la littérature

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