抄録
Objective: The first treatment selection for thumb carpometacarpal osteoarthritis is conservative treatment. If this approach is not sufficiently effective, we consider surgical treatment. In the present study, we reviewed the surgical results of ligament reconstruction interposition arthroplasty of the thumb.
Methods: We performed ligament reconstruction interposition arthroplasty using a half slip of the flexor carpi radialis tendon in 12 joints in nine patients. Three patients were men and six were women with a mean age of 62 years (from 56 to 66 years) and a mean follow-up period of 8 months (from 6 to 10 months). According to Eaton’s radiographic classification, six joints were stage II, five joints were stage III, and one joint was stage IV. We used Futami’s grading system for clinical evaluation. The items evaluated were degree of pain, difficulties in Activities of Daily Living (ADL), Range of Motion (ROM), pinch strength, grip strength, and radiographic changes.
Results: Complete pain relief was obtained in nine joints after surgery. ADL and ROM of the thumb showed good recovery. Mean pinch strength improved from 2.1 to 2.3 kg and mean grip strength improved from 18 to 22 kg. Seven of 12 joints were excellent and two were good. The space between the base of the first metacarpal and the distal tip of the scaphoid showed narrowing. Two joints (one case) were significantly painful on heavy activities.
Conclusion: Ligament reconstruction interposition arthroplasty using a half slip of the flexor carpi radialis tendon for thumb carpometacarpal osteoarthritis was an effective method if we appreciate the features that ADL and ROM show good recovery specifically.
