Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Stauffer, A; Schwarz, Y; Uranyi, M; Schachinger, F; Girsch, W; Ganger, R; Farr, S.
Outcomes after thumb carpometacarpal joint stabilization with an abductor pollicis longus tendon strip for the treatment of chronic instability.
Arch Orthop Trauma Surg. 2020; 140(2):275-282
Doi: 10.1007/s00402-019-03302-8
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- Co-Autor*innen der Med Uni Graz
- Girsch Werner
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- Abstract:
- Instabilities of the thumb carpometacarpal (CMC) joint, caused by idiopathic ligamentous hyperlaxity, trauma or other conditions may lead to pain, functional impairment and eventually osteoarthritis. Several techniques have been described to enhance stability of the CMC 1. The aim of this study was to evaluate postoperative outcomes after CMC 1 joint stabilization using a soft-tissue procedure in patients with chronic instability. This study was designed as a retrospective study with a single follow-up visit after a minimum of 1 year postoperatively. All patients who underwent stabilization of the CMC 1 with an abductor pollicis longus (APL) tendon strip for chronic, habitual instability were re-assessed using clinical examination, dedicated outcome scores [Visual Analogue Scale (VAS); The Disability of the Arm, Shoulder and Hand (DASH) score; Nelson score; Kapandji opposition score], grip and pinch strength measurements, and radiographic examination. 12 patients (15 operated thumbs) with a mean age at surgery of 23.2 (± 9.3) years were included after a mean follow-up period of 3.5 (± 1.3) years. The postoperative outcomes indicated excellent results, with a mean DASH score of 13.3 (± 11.3), VAS 1.1 at rest (and 2.8 during stress) and Nelson score of 87.7 (± 11.3). Postoperative grip, pinch strength and passive stability were not significantly different between operated and non-operated sides (p = 0.852; p = 0.923 and p = 0.428, respectively). We observed one case of recurrent instability besides no other complications. However, patients with trapezium hypoplasia (5 of 12) were more prone to signs of radiographic instability during stress testing. Thumb carpometacarpal stabilization with an APL tendon strip yielded excellent clinical outcomes and low morbidity in the mid-term. However, long-term follow-up is needed to assess specifically whether patients with trapezium hypoplasia may be more prone to clinical symptom recurrence than those with normal anatomy. Level IV.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Arthroplasty - adverse effects
- Arthroplasty - methods
- Carpometacarpal Joints - surgery
- Female -
- Humans -
- Joint Instability - surgery
- Male -
- Outcome and Process Assessment, Health Care -
- Postoperative Complications - diagnosis
- Reconstructive Surgical Procedures - adverse effects
- Reconstructive Surgical Procedures - methods
- Recovery of Function -
- Retrospective Studies -
- Tendon Transfer - methods
- Thumb - surgery
- Find related publications in this database (Keywords)
- Carpometacarpal joint
- CMC joint
- Chronic instability
- Habitual dislocation
- Stabilization
- Abductor pollicis longus