J Korean Orthop Assoc.  2012 Feb;47(1):21-27. 10.4055/jkoa.2012.47.1.21.

Hematoma Distraction Arthroplasty after Trapeziectomy in Advanced Osteoarthritis of the Trapeziometacarpal Joint

• Kim BK
• Shin HD
• Kim KC
• Cha SM

• KMID: 1439988
• DOI: http://doi.org/10.4055/jkoa.2012.47.1.21

Abstract

PURPOSE
To investigate the clinical usefulness of hematoma distraction arthroplasty to treat advanced trapeoziometacarpal osteoarthritis of the thumb.
MATERIALS AND METHODS
We studied 12 cases (1 male, 11 females) with osteoarthritis of the thumb that was managed with hematoma distraction arthroplasty using K-wire fixation. Of the 12 cases, 7 were Littler-Eaton stage III and 5 were Littler-Eaton stage IV. We investigated operation time, preoperative and postoperative visual analogue scale (VAS) score, preoperative and postoperative range of motion, grip power and radiologic changes.
RESULTS
The mean patient age was 53.2 (39-61) years and the mean duration of follow-up was 19.5 (14-27) months. The average operation time was 52 minutes. The mean VAS scores at 6 and 12 months after the operation were 1.3 and 0.7, respectively. The range of motion and grip power of the finger improved postoperatively (15% in abduction, 18% in adduction, 25% in flexion, 14% in extension, 66% in grip power of the finger). On a simple 12-month postoperative radiologic exam, the interval between the scaphoid and first metacarpal bone had decreased 6.5 mm compared with the preoperative interval.
CONCLUSION
The surgical treatment using hematoma distraction arthroplasty for trapeziometacarpal osteoarthritis is an effective method for pain relief, improvement of motion range and finger-grip power.

Keyword

trapeziometacarpal joint; osteoarthritis; hematoma distraction arthroplasty

MeSH Terms

Arthroplasty
Fingers
Follow-Up Studies
Hand Strength
Hematoma
Humans
Joints
Male
Osteoarthritis
Range of Motion, Articular
Thumb

Figure

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  Figure 1 JAMAR® hand dynamometer (Preston, Jackson, MI, USA).

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  Figure 2 This graph shows preoperative and postoperative Scaphoid-thumb metacarpal distances at rest. Preop, preoperative; Postop #6 m, postoperative at 6 month; Postop #12 m, postoperative at 12 month.

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  Figure 3 A 55-year-old female who was diagnosed with advanced trapeziometacarpal joint osteoarthritis in Littler-Eaton stage III. (A) preoperative radiographs, (B) postoperative radiographs, (C) last follow-up radiographs (postoperative 12 months), (D) excised trapezium at the operation.

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