Martin Franz Langer1, Jörg Gerhard Grünert2, Frank Unglaub3, Martin Richter4, Jörg van Schoonhoven5, Simon Oeckenpöhler6. 1. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland. langer.martin@ukmuenster.de. 2. Kantonsspital St. Gallen, St. Gallen, Schweiz. 3. Vulpiusklinik Bad Rappenau, Bad Rappenau, Deutschland. 4. Malteser Krankenhaus Bonn/Rhein-Sieg, Bonn/Rhein-Sieg, Deutschland. 5. Rhön-Klinikum Campus Bad Neustadt, Bad Neustadt, Deutschland. 6. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland.
Abstract
OBJECTIVE: Creation of a pain-free, flexible and stable (pseudo) joint between the carpus and the base of the 1st metacarpal bone. INDICATIONS: Painful carpometacarpal (CMC)‑I joint due to primary or secondary osteoarthritis, CMC‑I instability. CONTRAINDICATIONS: Carpal instability, local infection, tumors. SURGICAL TECHNIQUE: Resection of the trapezium (and of the arthritic joint surfaces in CMC‑I and STT [scaphoid-trapezium-trapezoid-joint]), stabilization of the base of the 1st metacarpal bone by suspension with a distally pedicled strip of the flexor carpi radialis tendon or variants thereof. POSTOPERATIVE MANAGEMENT: Immobilization in a splint for 3-5 weeks, followed by hand therapy. RESULTS: Worldwide for almost 40 years, regardless of the exact technique, almost always (90%) significant pain reduction, increased strength in the grip and slightly less in the pinch grip, very good mobility, 85-95% very satisfied patients and very good long-term results.
OBJECTIVE: Creation of a pain-free, flexible and stable (pseudo) joint between the carpus and the base of the 1st metacarpal bone. INDICATIONS: Painful carpometacarpal (CMC)‑I joint due to primary or secondary osteoarthritis, CMC‑I instability. CONTRAINDICATIONS: Carpal instability, local infection, tumors. SURGICAL TECHNIQUE: Resection of the trapezium (and of the arthritic joint surfaces in CMC‑I and STT [scaphoid-trapezium-trapezoid-joint]), stabilization of the base of the 1st metacarpal bone by suspension with a distally pedicled strip of the flexor carpi radialis tendon or variants thereof. POSTOPERATIVE MANAGEMENT: Immobilization in a splint for 3-5 weeks, followed by hand therapy. RESULTS: Worldwide for almost 40 years, regardless of the exact technique, almost always (90%) significant pain reduction, increased strength in the grip and slightly less in the pinch grip, very good mobility, 85-95% very satisfied patients and very good long-term results.
Authors: Benton E Heyworth; Charles M Jobin; James T Monica; Scott A Crow; Jonathan H Lee; Melvin P Rosenwasser Journal: J Hand Surg Am Date: 2009 Jul-Aug Impact factor: 2.230