دورية أكاديمية
Outcomes of Revisions for Failed Trapeziometacarpal Joint Arthritis Surgery.
| العنوان: | Outcomes of Revisions for Failed Trapeziometacarpal Joint Arthritis Surgery. |
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| المؤلفون: | Munns JJ; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Matthias RC; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Zarezadeh A; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Struk AM; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Dell PC; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Jones CA; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Stein JM; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL., Wright TW; Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL. Electronic address: wrightw@ortho.ufl.edu. |
| المصدر: | The Journal of hand surgery [J Hand Surg Am] 2019 Sep; Vol. 44 (9), pp. 798.e1-798.e9. Date of Electronic Publication: 2018 Dec 07. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 7609631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-6564 (Electronic) Linking ISSN: 03635023 NLM ISO Abbreviation: J Hand Surg Am Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Elsevier Original Publication: St. Louis, Mosby. |
| مواضيع طبية MeSH: | Arthroplasty/*methods , Metacarpal Bones/*surgery , Osteoarthritis/*surgery , Trapezium Bone/*surgery, Aged ; Aged, 80 and over ; Disability Evaluation ; Female ; Hand Strength ; Humans ; Male ; Metacarpal Bones/diagnostic imaging ; Middle Aged ; Osteoarthritis/diagnostic imaging ; Pain Measurement ; Postoperative Complications/diagnostic imaging ; Postoperative Complications/surgery ; Range of Motion, Articular ; Reoperation ; Retrospective Studies ; Trapezium Bone/diagnostic imaging ; Treatment Failure |
| مستخلص: | Purpose: We compare outcomes of revision surgery for trapeziometacarpal (TM) arthritis with outcomes for both primary and revision surgery for TM arthritis reported in the literature. We hypothesized that patients undergoing revision surgery for TM arthritis would demonstrate pain and functional outcome scores that were worse than those of patients undergoing primary TM surgery. Methods: A retrospective analysis of all patients undergoing revision TM surgery at a single institution from 1995 to 2015 was performed. Eighty-three patients (86 hands) met the inclusion criteria. Of these, 25 patients (27 hands) were available for follow-up via phone survey or clinical examination; 58 patients (59 hands) were available for chart review only. Patients available for phone survey or clinical examination were evaluated with the visual analog scale, Disabilities of the Arm, Shoulder, and Hand score, and the Conolly-Rath evaluation method. Patients available for clinical examination were also evaluated with grip strength, pinch strength, and radiographs. Results: Median follow-up was 8.5 years (range, 2.0-21.2 years). Twenty percent of patients experienced postoperative complications, most commonly pin problems (7%). Of the 27 hands available for interview or clinical examination, 15 were dominant and 12 were nondominant. The average visual analog scale was 28.2 (SD, 29.7). Disabilities of the Arm, Shoulder, and Hand scores averaged 32.0 (SD, 20.8). According to the Conolly and Rath criteria, 10 patients had a good outcome, 7 were fair, and 10 were poor. For the group of 13 patients who underwent physical examination, average adduction was 42° in the affected side versus 51° in the nonaffected side. Radial abduction was 58° in the affected side versus 65° in the nonaffected side. Palmar abduction was 53° versus 85° in each group, respectively. Tip finger pinch was 3.4 kg for the affected hand versus 4.0 kg for the nonaffected side. Key pinch was 4.7 and 5.5 kg, respectively. Grip strength was measured as 22.1 kg in the affected side versus 27.6 kg in the contralateral side when adjusted for dominance. Conclusions: In our study group, revision surgery for unsuccessful primary TM surgery demonstrated results inferior to those previously reported for primary surgery for TM arthritis but similar to prior studies of revision TM surgery. Revision surgery, however, can result in satisfactory long-term outcomes particularly when metacarpophalangeal joint pathology is addressed and complications are avoided. Type of Study/level of Evidence: Therapeutic IV. (Copyright © 2019 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Kapandji score; outcomes; reconstruction; salvage procedures; trapeziometacarpal arthritis |
| تواريخ الأحداث: | Date Created: 20181212 Date Completed: 20201013 Latest Revision: 20201013 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jhsa.2018.10.025 |
| PMID: | 30528967 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1531-6564 |
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| DOI: | 10.1016/j.jhsa.2018.10.025 |