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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

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Trapezium bone resection arthroplasty and suspension with suture-button for the treatment of trapezium-metacarpal osteoarthritis: long-term follow-up in a Colombian cohort

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  • presenting/speaker Carlos Gonzalez - Clinica del campestre, Medellin, Colombia
  • David Suarez - Clinica del campestre, Medellin, Colombia
  • Daniel Vanegas - Clinica del campestre, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin, Colombia
  • Camilo Restrepo - Clinica del campestre, Facultad de Medicina, Universidad Pontificia Bolivariana, Medellin, Colombia
  • Ana Milena Herrera - Clinica del campestre, Medellin, Colombia

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. DocIFSSH19-202

doi: 10.3205/19ifssh1088, urn:nbn:de:0183-19ifssh10884

Published: February 6, 2020

© 2020 Gonzalez et al.
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

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Objectives/Interrogation: Osteoarthritis of the trapezium-metacarpal thumb joint, the most common and debilitating degenerative osteoarthritic condition of the hand, occurs in approximately 25% of postmenopausal women; it requires management in case of severe pain and decreased function. Surgical options include arthrodesis versus arthroplasty; the latter uses complete or partial trapeziectomy. However, the tendency to collapse hinders prompt rehabilitation. The suspension with suture-button avoids the use of tendon grafts and favors early rehabilitation.

Methods: Retrospective study of clinical results of a cohort of patients with osteoarthritis of the trapeziometacarpal joint of the thumb, treated with a trapezium resection arthroplasty plus suspension with suture-button. In the study, we included a total of 25 patients (30 thumbs). Functional recovery and pain level were assessed objectively through the grip and pinch strength tests, the range of motion, Quick DASH and Kapandji scores, and visual analog scale (VAS) of pain.

Results and Conclusions: The average age was 62.2 ± 8.3 years; 23 women and two men; there was bilateral involvement in 5 patients. The preoperative Eaton classification was II in six, III in thirteen, and IV in eleven thumbs. The medians of follow-up times and Quick DASH scores were 24 months (range, 6-96) and 20.5 (range, 0-61.4), respectively. The grip and pinch strengths were 90% and 96.3%, of the non-surgical side, respectively. The average of palmar and radial abduction was 84.1% and 92.3%, of the non-operated thumb, respectively. The average Kapandji score for all operated thumbs was 9.25. Three cases presented long-term complications; there was one case of sensory branch neuroma, one of regional pain syndrome, and one fracture of the second metacarpal.

In our population, trapeziometacarpal arthroplasty with suture-button provides good functional results for patients with osteoarthritis of the trapeziometacarpal thumb joint, especially in pain relief, satisfaction, and early reincorporation to work and daily activities.