Article

Carpal boss is a symptomatic bony protrusion on the dorsal surface of the wrist
at the base of the 2nd and/or 3rd metacarpal. The goal of this study was to
assess the reliability and safety of simply resecting the exostosis. From 1994 to
2014, 29 cases of carpal boss were treated by simple resection. Twenty-five of
these patients were subsequently assessed by telephone questionnaire at a mean of
8 years' follow-up (range 1.1 to 20 years). There were no cases of recurrence;
however, 1 patient reported carpometacarpal instability requiring fusion, 5 years
after surgery. Eight of the 24 patients without fusion (33%) reported moderate
episodic pain (visual analog scale [VAS] pain: mean, 2.3/10, range 1 to 4). Range
of motion improved in 8 cases (33%), was unchanged in 11 (46%) and decreased in 5
(21%). Twenty patients (83%) had no functional impairment; 4 reported impairment
during unusual hand movements. Fifteen patients considered themselves cured
(60%), 9 considered their status improved (36%) and one - the patient who
required fusion - considered his status unchanged. Patients were very satisfied
with the procedure in 15 cases (60%) and satisfied in 10 (40%). In all cases,
features of dysplasia were present and associated with secondary osteoarthritis
limited to the area of impingement. The single failure was most likely due to
excessive bone resection. Simple exostosis resection is sufficient to effectively
treat carpal boss. Fusion should be reserved for the rare cases of secondary
metacarpal instability.
CI - Copyright (c) 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS