Outcomes of Arthrodesis of the Metacarpophalangeal Joint of the Thumb for Sequelae of Collateral Ligament Injuries: A Series of 18 Cases with 6-Year Follow-Up.

IF 0.5 Q4 SURGERY Journal of Hand Surgery-Asian-Pacific Volume Pub Date : 2024-06-01 Epub Date: 2024-05-10 DOI:10.1142/S242483552450019X
Gaetan Vanpoulle, Louis Ducharne, Ioana Ivan, Denis Corcella, Alexandra Forli
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Abstract

Background: Untreated or insufficiently treated collateral ligament injuries of the thumb metacarpophalangeal (MP) joint can lead to instability or even osteoarthritis. Arthrodesis is one of the treatment options available for the treatment of the sequelae of collateral ligament injuries. The objective of our study was to evaluate the radiological, clinical and functional outcomes of MP joint arthrodesis performed for sequelae of collateral ligament injuries. Methods: We conducted a retrospective, single-centre study and reviewed the files of patients who had a thumb MP joint arthrodesis following a collateral ligament injury between 2011 and 2019. We collected patient's demographic data and the results of the radiological and clinical examinations. Results: Eighteen patients were included in the study. The average age was of 53.6 years and the time between injury to arthrodesis averaged 7 years. Four patients (22%) had nonunion. In the remaining 14 patients with solid union at an average of 72 months follow-up, the visual analogue pain score at rest was 0.14, the thumb opposition was 82%, grip strength 85%, tip pinch 92% and key pinch 79% of the contralateral side. Conclusions: The clinical and functional results of patients with a successful arthrodesis are satisfactory with restoration of good grip and pinch strength. Despite a lack of thumb MP joint flexion, stability allowed force transmission and may be preferred for manual workers. Level of Evidence: Level IV (Therapeutic).

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拇指掌指关节矫形术治疗副韧带损伤后遗症的疗效:随访 6 年的 18 例系列病例。
背景:拇指掌指关节(MP)副韧带损伤如不及时治疗或治疗不充分,可导致关节不稳定甚至骨关节炎。关节置换术是治疗副韧带损伤后遗症的方法之一。我们研究的目的是评估因副韧带损伤后遗症而进行的 MP 关节置换术的放射学、临床和功能效果。研究方法我们开展了一项回顾性单中心研究,并查阅了 2011 年至 2019 年期间因副侧韧带损伤而接受拇指 MP 关节置换术的患者档案。我们收集了患者的人口统计学数据以及放射学和临床检查结果。研究结果研究共纳入了 18 名患者。平均年龄为 53.6 岁,从受伤到关节置换术的平均间隔时间为 7 年。四名患者(22%)的关节未愈合。在平均 72 个月的随访中,其余 14 名患者的关节结合牢固,静息时的视觉模拟疼痛评分为 0.14,拇指对立率为 82%,握力为 85%,尖捏为 92%,键捏为 79%。结论是关节置换术成功后,患者的临床和功能效果令人满意,并恢复了良好的握力和捏力。尽管拇指MP关节缺乏屈曲,但其稳定性允许力量传递,可能是体力劳动者的首选。证据等级:四级(治疗)。
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