Artikel
Surgical technique of the trapeziometacarpal and scapho-trapezoid-trapezoidal pyrocarbon “burger arthroplasty”
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Autoren
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Camilo Chaves
- Université Paris XI, Le Kremlin-Bicêtre, France
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Philippe Bellemère
- Institut de la Main, Saint Herblain, France
| Veröffentlicht: | 6. Februar 2020 |
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Gliederung
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Objectives/Interrogation: Trapezo-metacarpal and scapho-trapezotrapezoid arthroplasty based on pyrocarbon resurfacing implants is known as "burger arthroplasty". This technique was proposed in 2014 for the treatment of early stages of symptomatic and debilitating peritrapezial osteoarthritis.
This presentation exposes a video of the detailed the surgical technique.
Methods: A double approach is required. A dorsal approach to access the base of the carpo-metacarpal joint and a palmar approach to access the scapho-trapezoid-trapezoidal joint.
Through the dorsal approach, the extensor pollicis longus and brevis are dissected and protected. The articular capsule is opened, and the proximal base of the metacarpal is prepared.
Medial and lateral osteophytic metacarpal horns are resected. The metacarpal articular surface is prepared in a "champagne cork" shape.
Trapezial horns are resected. Both surfaces are gently blurred in order to homogenize the surfaces.
At this point the trial implant are tested for size and stability and the final implant is selected.
Through the palmar approach the scapho-trapezoid-trapezoidal joint is accessed. Scapho-trapezoid surface is prepared by resecting the subchondral surfaces and the surfaces are gently blurred to assure homogeneity. At this point the trial implant is tested for stability and size.
Preoperative fluoroscopy confirms the stability of the trial implants and the final implants are interposed between the surfaces.
The articular capsules are sutured, and the carpo-metacarpal capsule is reinforced by an anchor fixed on the dorsal aspect of the first metacarpal.
Results and Conclusions: The trapezo-metacarpal and scapho-trapezotrapezoid arthroplasty based on pyrocarbon resurfacing implants is known as "burger arthroplasty" is a new technique to treat early stages of symptomatic and debilitating peritrapezial osteoarthritis.
This technique offers a new therapeutic tool to hand surgeons that aim to propose a more conservative procedure compared to trapezectomy or arthroplasties.
