Rhizarthrosis of carpometacarpal (CMC) joint of a thumb


Authors: J. Pilný 1;  M. Jindra 1;  J. Krejzová 2;  M. Řihošková 3;  K. Bažantová 4
Authors‘ workplace: Ortopedické oddělení, Pardubická krajská nemocnice a. s. 1Fakulta medicínských studií, Univerzita Pardubice 1;  Soukromá revmatologická ambulance, Hradec Králové, 3Revmatologická ambulance Nemocnice s poliklinikou Havířov, 4Rehabilitační oddělení, Chrudimská nemocnice a. s. 2
Published in: Čes. Revmatol., 16, 2008, No. 3, p. 110-113.
Category: Original Papers

Overview

The involvement of the carpometacarpal (CMC) joint of hand is frequent in women in the fifth decade of life. It is caused by an overload based on instability of either traumatic or hypermobile etiology. The authors present a scheme of the treatment of CMC joint involvement in 92 joints and the indication according to Littler-Eaton classification. The authors are able to diagnose and distinguish instabilities using arthroscopy. Therefore the group contains also operations in patients with instabilities, that were performed preventively. An arthrodesis of CMC joint was performed in 26 patients, the Burton – Pellegrini procedure in 4 patients, Menon’s procedure in 39 patients, arthroscopic treatment of joint capsula in instabilities in 14 patients with hypermobility and Littler-Eaton arthroplasty in 9 patients. The results in patients after the Menon’s procedure (group I) and after an arthrodesis (group II) after 4–94 months using the Hobby – Lyall – Meggit method have been evaluated. In patients with arthrodesis, 42% were free of pain, 47% with pain after larger exercise and 11% with pain limiting common activities. In grip strength evaluation in comparison to the other side, 30% of pacients of group I were without limitation, 55% had a decreased grip strength and 15% could not be evaluated due to performed operation on both sides. In group II, 53% of patients had no grip strength limitations, 35% had a decreased grip strength and in 12%, the results could not be evaluated. In thumb abduction evaluation of group I, 10% of patients had abduction less than 30° and the rest more than 30°. In group II, 18% of patients had abduction less than 30° and 82% more than 30°. In the overall evaluation of group I (Menon’s arthroplasty), in 30% of patients results were evaluated as excellent, in 60% as a good and in 10% as bad. In the group II (arthrodesis), 42% were evaluated as an excellent, 47% as a good and 11% as a bad result. There was no significant difference in results between Menon’s method and arthrodesis.

Key words:
carpometacarpal arthrosis, carpometacarpal arthroplasty, carpometacarpal arthrodesis, carpometacarpal arthroscopy


Sources

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Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
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