The Biomechanical Consequences of Trapeziectomy and Partial Trapezoidectomy in the Treatment of Thumb Carpometacarpal and Scaphotrapeziotrapezoid Arthritis.
J Hand Surg Am
; 45(3): 257.e1-257.e7, 2020 Mar.
Article
in En
| MEDLINE
| ID: mdl-31421939
ABSTRACT
PURPOSE:
To determine, using a biomechanical cadaveric model, whether, in the treatment of thumb carpometacarpal and scaphotrapeziotrapezoid arthritis, partial trapezoid resection following trapeziectomy causes carpal, specifically lunocapitate and scapholunate, instability.METHODS:
Eight fresh-frozen mid-forearm cadaver specimens with type I lunates and devoid of basilar thumb arthritis were used in the study. Specimens were mounted onto a wrist simulator applying cyclical wrist flexion/extension and radial/ulnar deviation motions. Carpal kinematics, specifically lunocapitate and scapholunate joint relationships, were measured at 4 different conditions (1) a native intact state, (2) after trapeziectomy, (3) after 2-mm partial trapezoid resection, and (4) after 4-mm partial trapezoid resection.RESULTS:
During both flexion/extension and radial/ulnar deviation of the wrist, the lunocapitate and scapholunate joint relationship did not show any notable change following any of trapeziectomy, 2-mm, or 4-mm trapezoid resection compared with the intact state. Changes to the lunocapitate and scapholunate angles were clinically insignificant-a maximum of 6° and 4° change, respectively.CONCLUSIONS:
This biomechanical cadaveric study shows that performing a trapeziectomy followed by up to 4 mm of proximal trapezoid resection has a negligible effect upon carpal, specifically lunocapitate and scapholunate, stability. Further research is needed to elucidate the long-term clinical consequences of limited trapezoid resection in vivo. CLINICAL RELEVANCE There may be no clinically relevant effects of resection of up to 4 mm of trapezoid in the surgical management of combined basilar thumb and scaphotrapeziotrapezoid arthritis.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Lunate Bone
/
Carpal Bones
/
Carpal Joints
Limits:
Humans
Language:
En
Journal:
J Hand Surg Am
Year:
2020
Type:
Article
Affiliation country:
Mongolia