Article

Arthroplasty of the scaphoid-trapezium-trapezoid and carpometacarpal joints.

Institut Kaplan for surgery of the Hand and Upper Extremity, Paseo Bonanova, 9, Barcelona 08022, Spain. Electronic address: .
Hand clinics (Impact Factor: 0.69). 02/2013; 29(1):57-68. DOI: 10.1016/j.hcl.2012.08.021
Source: PubMed

ABSTRACT Resection arthroplasty is an old, and yet reliable, solution for the isolated osteoarthritis (OA) of some joints of the hand. With complication low rates, this technically undemanding option is ideal for scapho-trapezial-trapezoidal joint OA, as well as for the OA of the carpometacarpal joints of the fingers. This paper reviews its indications, surgical technique, and results.

1 Bookmark
 · 
303 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Scaphotrapeziotrapezoid (STT) joint osteoarthritis accounts for 13% of all wrist arthritis cases. The arthroscopic treatment combines radial midcarpal portal and STT portal called 1-2 midcarpal portal. We performed 13 isolated resections from the scaphoid distal pole. Patients were only women (average age, 58 years). Pain, mobility, and muscular strength improved significantly. At the same time, we fitted an interposition pyrocarbon implant after resection in 13 patients (average age, 67 years). We had 2 implant dislocations due to technical errors. Outcome quality optimized by the initial mini-invasive approach and arthroscopy should make selection of some treatment indications possible.
    Hand clinics 08/2011; 27(3):319-22. · 0.69 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The carpal scaphoid cannot be partially or totally excised without paying a functional penalty, usually in the form of carpal instability. In selected conditions, however, a partial scaphoidectomy may be preferred over other less reliable alternatives. These include excision of a small fragment of a fractured proximal pole when there is no injury to the scapholunate ligaments; excision of the distal fragment of a nonunited, arthritic distal-third scaphoid fracture; resection-arthroplasty of isolated STT osteoarthritis; and distal scaphoid excision to improve midcarpal function after a radioscapholunate fusion. In this article, both the pathomechanics and clinical results of such techniques are discussed.
    Hand Clinics 12/2001; 17(4):687-95, x. · 1.07 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: When the wrist is grasping an object, at least four mechanisms of carpal stabilization are involved-one for each carpal row (proximal and distal), one for the midcarpal joint, and one for the radiocarpal joint. These mechanisms are based on the general principle that, under load-bearing conditions, any bone tends to rotate into a specific direction depending upon several factors, including the position of the wrist at the time of loading, the direction of the forces being transferred, and the inclination and shape of the articular surfaces on which the bone stands. Such an attempted displacement is initially guided and later neutralized by appropriately oriented ligaments, with which a new equilibrium is achieved. An injury or disease affecting any one of these mechanisms results in a specific type of carpal instability, depending upon which mechanism(s) has been violated. Only through a thorough understanding of these mechanisms of wrist stabilization will our ability to successfully treat these problems be enhanced.
    Hand Clinics 03/1997; 13(1):151-8. · 1.07 Impact Factor