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Published in: Archives of Orthopaedic and Trauma Surgery 7/2023

21-01-2023 | Osteoarthrosis | Handsurgery

Trapeziectomy with ligament reconstruction and tendon interposition arthroplasty continuously improves hand functions up to 5-year postoperatively

Authors: Shingo Komura, Akihiro Hirakawa, Hitoshi Hirose, Haruhiko Akiyama

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2023

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Abstract

Introduction

Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty is a reliable surgical procedure for the treatment of thumb carpometacarpal osteoarthritis, which provides good long-term outcomes. However, it remains unclear when the greatest benefit of this procedure can be obtained, and how long these benefits will continue. Therefore, we investigated the middle- to long-term advantages of this procedure by analysing the chronological changes in clinical outcomes by following the same patients from 1 year to a median 5 years after trapeziectomy with LRTI.

Materials and methods

Sixteen thumbs that completed consecutive clinical and radiographic evaluations preoperatively, 1 year, 2 years, 3 years, and median 5 years (range 4–8 years) after trapeziectomy with LRTI were included in this study. We investigated grip strength, pinch strength, range of motion (ROM) of the thumb, a visual analogue scale for pain, Disabilities of Arm, Shoulder and Hand (DASH) score, Hand20 questionnaire score, trapezial space height, and trapezial space ratio at every time point.

Results

Hand strength (grip, pulp, and lateral pinch), palmar abduction, DASH score, and Hand20 questionnaire score were improved at 1 year postoperatively while the radial abduction showed significant improvement at the final follow-up. Moreover, pulp pinch strength, DASH score, and Hand20 questionnaire score continued to improve significantly from 1 year postoperatively to the final follow-up. Conversely, trapezial space height and ratio continuously decreased up to the final follow-up.

Conclusions

Trapeziectomy with LRTI consecutively improved the pinch strength, ROM of the thumb, DASH score, and Hand20 questionnaire score up to 5 years postoperatively. It also maintained the improvement of the other clinical outcomes up to 5 years postoperatively except for radiological findings.
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Literature
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go back to reference De Smet L, Vandenberghe L, Degreef I (2013) Long-term outcome of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus prosthesis arthroplasty for basal joint osteoarthritis of the thumb. Acta Orthop Belg 79(2):146–149PubMed De Smet L, Vandenberghe L, Degreef I (2013) Long-term outcome of trapeziectomy with ligament reconstruction and tendon interposition (LRTI) versus prosthesis arthroplasty for basal joint osteoarthritis of the thumb. Acta Orthop Belg 79(2):146–149PubMed
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Metadata
Title
Trapeziectomy with ligament reconstruction and tendon interposition arthroplasty continuously improves hand functions up to 5-year postoperatively
Authors
Shingo Komura
Akihiro Hirakawa
Hitoshi Hirose
Haruhiko Akiyama
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 7/2023
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-023-04779-0

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