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Revue de chirurgie orthopédique et traumatologique (2011) 97, 715—716
Disponible en ligne sur
www.sciencedirect.com
MÉMOIRE ORIGINAL
Mise en boucle de l’hemi-tendon de l’abductor
pollicis longus autour du premier ligament
intermetacarpien comme interposition
post-trapeziectomie : une étude à un an de recul夽
Abductor pollicis longus hemi-tendon looping around the first
intermetacarpal ligament as interposition following trapeziectomy:
A one-year follow-up study
L. Rocchi a, A. Merolli a,∗, C. Cotroneo b, A. Morini a, F. Brunelli c, F. Catalano a
a
Orthopaedics & Hand Surgery, The Catholic University School of Medicine, Rome, Italie
Physiotherapy Service, Columbus Complex, The Catholic University School of Medicine, Rome, Italie
c
Institut de la Main, Jouvenet Private Hospital, Paris, France
b
Acceptation définitive le : 13 juillet 2011
KEYWORDS
Thumb
carpo-metacarpal
joint osteoarthritis;
Ligamentoplasty;
Trapeziectomy;
Trapezium
Summary
Background. — Trapeziectomy and ligament reconstruction is favoured by surgeons concerned
that telescoping of the thumb may reduce its function. However, theoretically ligamentoplasties
are at risk to develop tendinosis or tendon rupture or trigger a complex regional pain syndrome
type 1.
Hypothesis. — Authors tested the looping of a slip from the Abductor Pollicis Longus tendon
around the first intermetacarpal ligament. They intended to use a surgical treatment, which
does not require bone tunneling or looping around a tendon. Their results support the hypothesis
that this new technique is a valid addition among treatments for carpo-metacarpal arthritis.
Patients and Methods. — Forty-two patients were followed-up to 1 year. Each patient had
subjective assessment for: pain; function (DASH score); overall satisfaction. An objective assessment was used for: first web span angle; abduction and opposition; key pinch; grip strength.
Tests were performed prior to surgery, then at 3, 6 and 12 months. X-ray films were taken to
monitor thumb height.
DOI de l’article original : 10.1016/j.otsr.2011.05.008.
Cet article peut être consulté in extenso dans la version anglaise de la revue
Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.
∗ Auteur correspondant. Via Cassia 571, I-00189 Rome, Italy.
Adresse e-mail : [email protected] (A. Merolli).
夽
1877-0517/$ – see front matter © 2011 Elsevier Masson SAS. Tous droits réservés.
doi:10.1016/j.rcot.2011.09.009
Author's personal copy
716
L. Rocchi et al.
Results. — A substantial improvement in all these parameters was measured in all patients. Xray films showed the maintenance of a physiological height after one year. We recorded one
complication of keloid and two of temporary dysesthesia but no case of tendinosis, delayed
rupture, or CRPS 1. Mean operative time was 27 minutes.
Discussion. — Simplification and search for a technique, which avoid the looping around a tendon is why the authors undertook this study. Advantages are the small number of required
steps, short time of surgery and comfortable postoperative rehab regimen for the patient.
The technique provides a distal anchoring point (without bone tunneling). It is quite respectful of anatomy and physiology, in minimizing the re-routing of functioning tendons. We
propose it as an effective procedure both to expand the armamentarium for treating the thumb
carpo-metacarpal joint osteoarthritis and/or to simplify the ligamentoplasties already in use.
Level of evidence. — Level IV. Retrospective therapeutic study.
© 2011 Elsevier Masson SAS. All rights reserved.