gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Managing Painful Wrist and Trapezio-Metacarpal Arthritis in Patients with SCI Using Surgical Joint Denervation

Meeting Abstract

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  • presenting/speaker Andreas Gohritz - Swiss Paraplegic Centre, Nottwil, Switzerland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1986

doi: 10.3205/19ifssh0986, urn:nbn:de:0183-19ifssh09864

Published: February 6, 2020

© 2020 Gohritz.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: Patients with spinal cord injury (SCI) have an increased incidence of painful wrist and trapezio-metacarpal arthritis due to the accumulated long-term load on their upper extremity or post-traumatically. However, many of the affected individuals opt against standard bony procedures, such as arthoplasty, joint implants or arthrodesis for fear of lengthy immobilisation, loss of motion, and other complications, e.g. postoperative instability.

Methods: We have studied the effects of alternative surgical denervation in 8 wrist and 7 trapezio-metacarpal joints (2 bilateral, 1 combined) during a 4-year period in 8 paraplegic and 4 tetraplegic individuals.

Results and Conclusions: Pain intensity regarding dropped by at least 50% on the visual analogue scale in all cases and results were rated as satisfactory by all patients.

No conversion to total joint arthrodesis was necessary within the follow-up time.

Surgical joint denervation seems to be an underused option to treat painful osteoarthritis in SCI patients as we are unaware of a previous description.

However, compared to more invasive methods, it provides important advantages as preserved joint integrity, no need for postoperative immobilization, technical simplicity, inexpensiveness and with low risk profile. All alternatives remain possible for future, e. g. arthrodesis or arthroplasty prosthesis and results can be reliably anticipated by preoperative test nerve blocks.

This study shows that surgical denervation of the wrist and thumb carpo-metacarpal joint is a minimally invasive option to reduce pain and preserve motion and function in this population with special demands.