Article

Basal thumb arthritis is less common in men, but the functional implication is different in this manual worker or active retired population.
The objective was
to analyse the results of three surgical procedure in an exclusively men's
population. Twenty-eight patients (19 partial trapeziectomy with interposition of
a chondrocostal autograft, seven total trapeziectomy and two prosthesis), with a
mean age of 69 years old, were reviewed at a mean follow-up of 71 months.
Mobility and pain were similar in the three populations. But the strength and
Dash scores were better in the cartilage group. Radiologically the length of the
thumb ray was greater in the cartilage group and no signs of loosening were
observed in the prosthesis group. The surgery of reference in this population is
the arthrodesis of the trapeziometacarpal joint. But the lack of mobility is
disabling, the strength is questionable and painlessness varies due to high rates
of non-union. Only one study compared four surgical procedures in an exclusively
male population and total trapeziectomy seemed to give the best results. But this
technique carries risk of shortening of the thumb ray. Even if the comparison is
difficult, the association of partial trapeziectomy with interposition of costal
cartilage graft seems to give better stability to the thumb column by preserving
length as well as greater strength compared to total trapeziectomy. We advocate
this procedure for basal thumb arthritis in men.
CI - Copyright (c) 2010 Elsevier Masson SAS. All rights reserved.

Langue : FRANCAIS