Results of the Dubert procedure for chronic painful fracture–dislocations of the fifth carpometacarpal joint. A report of 6 cases

Meraghni, Nadhir; Bacle, Guillaume; Marteau, Émilie; Bouju, Yves; Laulan, J.

doi:10.1016/j.hansur.2017.04.005

Cited by 4 publications

(7 citation statements)

References 17 publications

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“…Historically, these sequential lesions were surgically treated by HM arthrodesis. Recently Dubert [7][8][9] popularized a procedure involving arthroplastic resection of the 5 th metacarpal (M5) base and inter-metacarpal fusion of the bases of M4 and M5 restoring certainly the length of the 4 th and 5 th metacarpal but decreasing the rank of motion the fifth ray [7,8]. The "scaphoid trapezium pyrocarbon implant" type pyrocarbon implant (STPI) was initially developed to treat scapho-trapezo-trapezoidal arthritis [10][11][12] (Figure 1).…”

Section: Clinical Resultsmentioning

confidence: 99%

“…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%

“…One of the limiting points of this work is the small number of patients included as well as its retrospective nature. Although none of the published series has a large cohort, those described with the Dubert procedure by Bain and Meraghni respectively include five and six patients [7,9]. On the other hand, in the case of associated carpometacar- pal arthritis of the 4 th ray, it is possible to imagine that the results would be worse than the existing osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in the case of associated carpometacar- pal arthritis of the 4 th ray, it is possible to imagine that the results would be worse than the existing osteoarthritis. It would be interesting to carry out a study involving a larger number of patients, and to be able to distinguish between patients with and without associated involvement of the fourth CMC joint for whom the Dubert procedure is not recommended [7].…”

Section: Discussionmentioning

confidence: 99%

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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: Clinical Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Baumann¹,

Klein²,

Emmanuel³

et al. 2020

J Orthop Surg Tech

View full text Add to dashboard Cite

show abstract

“… 3 In cases of chronic symptomatic lesions of the base of the 5 th CMC, an alternative is to perform the Dubert technique, in which a resection of the base of the metacarpal is performed, associated with the creation of a synostosis next to the 4 th CMC. 31 To avoid such complications, once a diagnosis of carpometacarpal fractures or dislocations is made, early reduction, adequate stabilization and rehabilitation as soon as possible should be implemented.…”

Section: Treatmentmentioning

confidence: 99%

Reconhecimento precoce e tratamento das fraturas e luxações carpometacarpais

Novak

Giostri

2021

Rev Bras Ortop (Sao Paulo)

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ResumoAs lesões na região carpometacarpal (CMC) podem passar despercebidas em mais da metade dos casos. O diagnóstico precoce é determinante para o tratamento. Embora clinicamente o paciente já possa demonstrar que de fato ocorreu a lesão, radiografias apropriadas, principalmente na incidência em perfil, são fundamentais para o diagnóstico. A lesão mais comum afeta as articulações de 4° e 5° dedos. O tratamento vai depender do tipo da lesão e o grau de envolvimento das articulações. Geralmente, é necessária redução e fixação.Quando apenas um raio é acometido, habitualmente o 5°, pode ser feita redução fechada e fixação com fios de Kirschner. Nos casos complexos, faz-se necessária a redução aberta e fixação, sendo os fios de Kirschner os materiais mais comumente usados. Após a retirada dos fios, intensifica-se a reabilitação.Se foi alcançada uma redução apropriada, esperam-se resultados funcionais e radiográficos satisfatórios.

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Intermetacarpal M4-M5 arthrodesis (Dubert procedure) for fifth carpometacarpal joint osteoarthritis: long-term functional outcomes

Druel¹,

Forli²,

Corcella³

2021

Hand Surgery and Rehabilitation

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Results of the Dubert procedure for chronic painful fracture–dislocations of the fifth carpometacarpal joint. A report of 6 cases

Cited by 4 publications

References 17 publications

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

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

Reconhecimento precoce e tratamento das fraturas e luxações carpometacarpais

Intermetacarpal M4-M5 arthrodesis (Dubert procedure) for fifth carpometacarpal joint osteoarthritis: long-term functional outcomes

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