This article appeared in a journal published by Elsevier. The
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This article appeared in a journal published by Elsevier. The
This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier’s archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright Author's personal copy 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.