Article
May be the artrhoplasty with spacer the best solution of CMC arthrosis in under seventy patients
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Authors
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Gaetano Carriere
- Villa Erbosa Hospital, Bologna, Italy
| Published: | February 6, 2020 |
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Outline
Text
Objectives/Interrogation: Maintenance of high of trapezium-metacarpal joint should be the aim in the CMC arthrosis Eaton's stage 2-3 surgery in under-seventy patients.
Methods: I used two different spacers in in my personal series of 190 consecutive cases of: Arthroplasty in CMC arthrosis, stages 2°-3° Eaton classification.
One hundred forty cases with Pirodisk (pirocarbon spacer, age thirty-eight to sixty-five, follow up from ten to one year), fifty cases Reg Joint (poliLactid acid biosorbable spacer, age from 45 to eighty-one, follow up five to one years).
The same technique for the Reg Joint, created an hole with specific tools into the biosorbable spacer.
The terminal end of FRC split is used to reconstruct the CMC dorsal ligament, "reinforced" from ALP detached from the 1° metacarpal base.
One hundred-ten (eighteen bilateral), twenty man (two bilateral) in Pirodisk series, forty women (four bilateral) and six man in Reg-Joint series.
Results and Conclusions: All patients were evaluated clinically, at 15, 30, 60 e 90 days, only twenty rx control and three Tc were done in first five months for persistent wrist pain.
One hundred and sixty-five patients compiled the quick-D.A.S.H. (Short disability of Harm-Shoulder and Hand) questionnaire (the average value was 17.5 point (from 13 to 28).
Kapandy value 8-10, (average nine)
Pain: V.A.S. 1.8 average (range 1-4), was 5.5 before surgery.
Pinch 4.6 (was 3.4 before surgery because of pain) similar to the other hand.
Grip: average 18.5 Kg (was 13 before surgery), 22 kg the value of the other hand.
No statistically difference were find between two groups.
All patients reached their best range of motion and were able to restart the normal work related activities in 2 to 6 months (average 2.8 months).
Eight patients were treated for trigger thumb and six for Dequervain disease at four-eight month from first surgery in Pirodisk series, only two woman was re-operated after eighteen months, replacing with reg-joint spacer.
On conclusion 90% of very-good and good results, 9% fair, 1% bad (two cases in pirodisk serie).
