Trapeziometacarpal Instability Treated with Modified Brunelli Ligamentoplasty

Botelheiro, J. C.

doi:10.1054/jhsb.2000.0473

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…[2][3][4][5][6][7] There is a large variety of surgical procedures to treat the disease. Early stages I and II according to Dell 8 can be treated with ligament reconstruction according to Eaton 9 or Brunelli, 10 by abductortomy according to Zancolli,11 or with osteotomy according to Wilson. 12 Another possibility is the arthroscopic debridement.…”

Section: Introductionmentioning

confidence: 99%

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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Section: Introductionmentioning

confidence: 99%

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Nufer

Goldhahn

Köhler

et al. 2007

Journal Orthopaedic Research

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“…The author developed this technique based on the assumption that the anterior oblique ligament plays a crucial role in sustaining joint stability [ 23 ]. This procedure, though quite complex, yielded promising results in a study in 1973, as well as in more recent studies, and has maintained its status as the preferred treatment for chronic thumb joint instability until today [ 20 , 27 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Radiological Influencing Factors in the Diagnosis of Painful Habitual Instability of the Thumb Basal Joint as a Precursor of Carpometacarpal Arthritis of the Thumb—A Retrospective Study

Winter

Hasiba-Pappas

Kamolz

et al. 2023

JPM

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Background: Painful habitual instability of the thumb basal joint (PHIT) is a rarely diagnosed condition that can severely impair hand function. Furthermore, it can increase the risk of developing carpometacarpal arthritis of the thumb (CMAOT). Clinical examination and radiographic imaging provide the foundation for a correct diagnosis, but early detection is still challenging. We investigated two objective, radiographically obtainable parameters as potential risk factors for PHIT. Methods: Clinical data and radiographic images of 33 patients suffering from PHIT were collected and compared to those of 35 people serving as the control group. The two main objectives, the slope angle and the bony offset of the thumb joint, were gathered from the X-rays and statistically analyzed. Results: The analysis showed no differences between the study and the control group concerning the slope angle. Gender and the bony offset, on the other hand, had a significant influence. Female sex and higher offset values were associated with an increased risk of PHIT. Conclusions: The results of this study prove a connection between a high bony offset and PHIT. We believe this information can be valuable in early detection and will allow more efficient treatment of this condition in the future.

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“…From findings on anatomical dissection of fresh frozen cadavers and other studies, we consider that that the ligament is taut in extension and abduction. 5 Rupture of this functionally and anatomically distinct ligament may cause symptomatic instability 6 and an increased pressure on the incongruous articular cartilage which may lead to osteoarthritis. A complete detachment of the volar ligaments is related to extensive palmar articular degeneration.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic instability of the trapeziometacarpal joint of the thumb

Takwale

Stanley

Shahane

2004

The Journal of Bone and Joint Surgery. British volume

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In 28 patients with a solitary diagnosis of instability of the trapeziometacarpal joint because of a rupture of the anterior oblique ligament, reconstruction was carried out using a slip of the tendon of flexor carpi radialis. We were able to review 26 patients. The results after a follow-up of four years seven months showed that most (87%) had significant relief from pain and symptoms. Seventeen were graded as good to excellent. The mean grip strength recovered to 86% of the contralateral side. Most patients (81%) felt that they had subjective improvement and would have undergone the operation again. A lesser functional result was seen in those who developed a flexion deformity because of overtightening of the reconstruction. Increased awareness of this lesion can lead to an early and clear diagnosis so that the patient may be advised adequately. We describe a specific, diagnostic, clinical test which we have used consistently and successfully.

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Trapeziometacarpal Instability Treated with Modified Brunelli Ligamentoplasty

Cited by 6 publications

References 6 publications

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Microstructural adaptation in trapezial bone due to subluxation of the thumb

Radiological Influencing Factors in the Diagnosis of Painful Habitual Instability of the Thumb Basal Joint as a Precursor of Carpometacarpal Arthritis of the Thumb—A Retrospective Study

Post-traumatic instability of the trapeziometacarpal joint of the thumb

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