Résultats à plus de cinq ans d'une série consécutive de 44 trapézectomies avec ligamentoplastie et interposition

Du, Catherine Le; Guéry, J; Laulan, J.

doi:10.1016/j.main.2004.04.004

Cited by 24 publications

(3 citation statements)

References 13 publications

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“…From a mechanical point of view, it allows to anchor the new ligament to a constant anatomic element, without the necessity to perform a tenoplasty around the flexor carpi radialis tendon, nor a transosseous tunnel. These characteristics permit the avoidance of complications such as tendinitis or tendon ruptures 26,47. Furthermore, in the authors’ opinion, they make the surgery easier to perform and easier to reproduce.…”

Section: Discussionmentioning

confidence: 94%

“…Many of the ligamentoplasties proposed in the literature are technically challenging: they may require the looping of the suspensory ligament around some of the tendons of the wrist (such as the tendon of the flexor carpi radialis), or the passage through transosseous tunnels (mostly through the first metacarpal) 13,23–25. These techniques can sometimes lead to complications due to the difficulty of execution or secondary inflammatory disorders such as inflammatory painful tendinopathies or tendon ruptures 14,26–28…”

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confidence: 99%

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F. Brunelli Ligamentoplasty as Treatment in Thumb Basal Joint Arthritis: Up to 9 Years Follow-up

Fulchignoni¹,

Morini²,

Panzera³

et al. 2020

Techniques in Hand &Amp; Upper Extremity Surgery

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Thumb basal joint arthritis treatment with biological arthroplasty is a widely used procedure in hand surgery centers. The several described techniques are based on the use of different tendons of the wrist, implying frequently a tenoplasty around flexor carpi radialis or transosseous tunnels to stabilize the articulation. The authors have been using, for many years, the technique conceived by F. Brunelli that relies on the anchorage of the volar band of the abductor pollicis longus tendon to the first intermetacarpal ligament, to obtain a suspension arthroplasty. Technical details are discussed. Sixty-seven patients in Eaton-Littler stage 2 or 3 with > 4 years follow-up after surgery were evaluated. Each patient expressed a subjective evaluation relating to pain, functionality, strength, esthetic aspect, and general satisfaction. The following parameters have been considered as objective data: the angle of the first web space, the abduction and opposition of the first digit, the pinch, and the strength. X-rays were also performed to verify the distance between the scaphoid and the first metacarpal. In 84% of cases, a significant improvement was found in the considered parameters. Joint space was maintained in 76% of cases at radiologic follow-up. No patient needed surgical revision. The tenoplasty conceived by F. Brunelli presents several advantages, including the simple and reproducible execution, short surgical time, and comfortable postoperative course for the patient. After mid-term follow-up, authors believe this procedure is particularly respectful of the anatomy and physiology of the first ray and gives optimal results in most of the cases, but, in patients with severe subluxation of the 1st metacarpal (identifiable as Eaton-Littler stage 3), it is less reliable, because of the degeneration of the intermetacarpal ligament.

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

F. Brunelli Ligamentoplasty as Treatment in Thumb Basal Joint Arthritis: Up to 9 Years Follow-up

Fulchignoni¹,

Morini²,

Panzera³

et al. 2020

Techniques in Hand &Amp; Upper Extremity Surgery

View full text Add to dashboard Cite

show abstract

“…Trapeziectomy with ligament reconstruction and tendon interposition is the preferred treatment of thumb osteoarthritis at our institution and has proved to be able to achieve good results in terms of functional recovery, patient’s satisfaction and postoperative complications (Armstrong et al, 1994; Ceruso et al, 1991; Le Dû et al, 2004). The donor site defect associated with this procedure is irrelevant as the use of a part of the APL tendon diminishes the forces acting on the thumb subluxation without affecting thumb abduction.…”

Section: Discussionmentioning

confidence: 99%

Trapeziectomy and tendon suspension with or without a Mitek anchor fixation in the thumb basal joint osteoarthritis

Nordback

Erba

Wehrli

et al. 2012

J Hand Surg Eur Vol

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Partial trapeziectomy with suspension ligamentoplasty is a commonly performed treatment of thumb osteoarthritis. Nevertheless, the post-operative recovery remains long and critical reason for which different modifications of the surgical technique have been proposed. To compare two suspension ligamentoplasty techniques, one with a mitek anchor and another without, a retrospective study of 55 consecutive operated patients was performed. A detailed clinical analysis of pain, function and a radiologic assessment of the trapeziometacarpal space were performed. Mitek anchor fixation was associated with a shorter convalescence period. However, in spite of an improved radiological maintenance of the scaphometacarpal space, mitek anchor fixation was associated with an impaired postoperative function and residual pain when compared with the conventional suspension ligamentoplasty procedure. Patient's satisfaction was comparable in both groups. In our series stabilization of the suspension ligamentoplasty procedure by the insertion of a mitek anchor did not bring the hoped benefits to the patients with a trapeziometacarpal arthritis.

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Microstructural adaptation in trapezial bone due to subluxation of the thumb

Nufer

Goldhahn

Köhler

et al. 2007

Journal Orthopaedic Research

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Although the thumb saddle is one of the most common sites of degenerative osteoarthritis in the hand, little is known about the altered microstructure in osteoarthritic trapezial bones. External forces resulting from subluxation of the carpometacarpal joint of the thumb (CMC I) should provoke microstructural changes in the trapezium. The purpose of this study was to compare the regional differences of the microstructure between osteoarthritic and healthy trapezial bones. Fifteen trapezia harvested from female patients with radiologically and clinically diagnosed saddle joint osteoarthritis (OA) were compared with 15 unaffected controls. Microstructural parameters, such as bone volume ratio (BV/TV), three-dimensional connectivity (Conn.D), trabecular number (Tb.N), and trabecular thickness (Tb.Th) were studied using a microcomputed tomography (microCT) system. While the trapezial height in OA was 22% less, the sclerotic subchondral bone layer thickness was 50% higher in OA compared with the control group (p < 0.001). In the OA group there was a 42% higher bone volume ratio (p 0.001), an 18% increase in Tb.Th (p ¼ 0.006), and a 10% greater Tb.N (p ¼ 0.034) compared with the control group. Although in both groups BV/TV was significantly lower in the radial region, the radial column showed the highest relative increase in bone volume and structure compared with the control group (þ67% BV/TV, þ20% Tb.Th, þ23% Tb.N). The reinforcement of the bony microstructure in CMC I OA, especially at the radial side, is a sign for bone adaptation reacting to radially shifted joint forces. This has to be considered during the development of new prosthetic alternatives. ß

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Résultats à plus de cinq ans d'une série consécutive de 44 trapézectomies avec ligamentoplastie et interposition

Cited by 24 publications

References 13 publications

F. Brunelli Ligamentoplasty as Treatment in Thumb Basal Joint Arthritis: Up to 9 Years Follow-up

F. Brunelli Ligamentoplasty as Treatment in Thumb Basal Joint Arthritis: Up to 9 Years Follow-up

Trapeziectomy and tendon suspension with or without a Mitek anchor fixation in the thumb basal joint osteoarthritis

Microstructural adaptation in trapezial bone due to subluxation of the thumb

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