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Hand Surg Rehabil. 2016 Sep;35(4):238-249. doi: 10.1016/j.hansur.2016.06.002. Epub 2016 Jul 21.

Surgery for trapeziometacarpal osteoarthritis.

Author information

1
Service de chirurgie de la main, chirurgie plastique et réparatrice des membres, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France.
2
Service de chirurgie de la main, chirurgie plastique et réparatrice des membres, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. Electronic address: rlegre@ap-hm.fr.

Abstract

Trapeziometacarpal (TMC) osteoarthritis is a common, disabling condition that mostly affects women. The demand for surgical treatment is growing and the patients are becoming younger, adding to the challenge. Surgery can only be proposed after failure of well-conducted conservative treatment and requires a complete X-ray assessment. In the early stages, conservative surgery measures can be used to stabilize the joint or realign it in cases of dysplasia, but in most cases, patients are seen with more advanced arthritis and joint replacement must be considered. The ideal arthroplasty technique has yet to be defined but nevertheless, the chosen technique must be well-suited to the patient's condition. Although many studies have been published on this topic, they do not help us define the treatment indications. Prospective studies focusing on the patient rather than evaluating a certain surgical technique are needed. Trapeziectomy with or without ligament reconstruction is still considered the gold standard, but the challenges associated with treating its complications limit its indications. Arthrodesis, interposition or arthroplasty are also viable therapeutic options. The patient must be sufficiently informed to be able to contribute to choosing the indication.

KEYWORDS:

Arthroplasty; First CM joint arthritis; Indication; Interposition; Prothèse; Rhizarthrose; Surgery; Thumb basal joint arthritis; Trapeziometacarpal osteoarthritis

PMID:
27781986
DOI:
10.1016/j.hansur.2016.06.002
[Indexed for MEDLINE]

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