Degenerative arthritis at the triscaphe joint (2022)

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The Journal of Hand Surgery

Volume 15, Issue 2,

March 1990

, Pages 232-235

Abstract

The clinical presentation of triscaphe arthritis and the results of arthrodesis are presented. Twenty-one patients had triscaphe arthrodesis for treatment of arthritis of the triscaphe joint between 1972 and 1986. Seven also had rotary subluxation of the scaphoid and one had Kienböck's disease. Twenty patients were available for examination at an average of 5 years after operation. All had relief of pain and the average flexion-extension arc was 101 degrees. One patient had a nonunion successfully treated by refusion, and in two patients a dystrophy developed, which was relieved by a stress loading program. No progression of arthritis was seen elsewhere in the wrist.

(Video) Scaphotrapezial Trapezoid (STT) Osteoarthritis

References (16)

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There are more references available in the full text version of this article.

Cited by (18)

  • Scaphotrapeziotrapezoid Arthrodesis: Systematic Review

    2022, Journal of Hand Surgery

    Scaphotrapeziotrapezoid (STT) arthrodesis surgery is used for various types of wrist pathologies. The objective of our study was to perform a systematic review of complications and outcomes after STT arthrodesis.

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    Several major databases were used to perform a systematic literature review inorder to obtain articles reporting complications and outcomes following STT arthrodesis.The primary purpose was to identify rates of nonunion and conversion to totalwrist arthrodesis. Secondary outcomes included wrist range of motion, grip strength, and Disabilities of the Arm Shoulder and Hand scores. A multivariable analysis was performed to evaluate factors associated with the primary and secondary outcomes of interest.

    Out of the 854 records identified in the primary literature search, 30 studies wereincluded in the analysis. A total of 1,429 procedures were performed for 1,404 patients. The pooled nonunion rate was 6.3% (95% CI, 3.5–9.9) and the rate of conversion to total wrist arthrodesis following the index STT was 4.2% (95% CI, 2.2–6.7). The mean pooled wrist flexion was 40.7° (95% CI, 30.8–50.5) and extension was 49.7° (95% CI, 43.5–55.8). At final follow-up, the mean pooled grip strength was 75.9% (95% CI, 69.3–82.5) of the nonsurgical contralateral hand. Compared with all other known indications, Kienbock disease had a statistically significant lower nonunion rate (14.1% vs 3.3%, respectively). Mixed-effects linear regression using patient-level data revealed that increasing age was significantly associated with complications, independent of occupation and diagnosis.

    Our study demonstrated a low failure rate and conversion to total wrist arthrodesis after STT arthrodesis and acceptable postoperative wrist range of motion and strength when compared to the contralateral hand.

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  • Ultrasound-Guided Interventional Procedures of the Wrist and Hand: Anatomy, Indications, and Techniques

    2016, Physical Medicine and Rehabilitation Clinics of North America

    The scaphoid is the most radial bone on the proximal carpal row and articulates with the distal radius, capitate, lunate, trapezium, and trapezoid.13 STT joint arthritis is the second most common pattern of wrist arthritis, observed in up to 15% of radiographic studies and 83.3% of cadaveric specimens.12,14–20 The STT joint is best visualized sonographically using a high-frequency linear-array transducer placed over the palmar aspect of the wrist with the forearm supinated.

  • Anterior traumatic axial disruption of mid carpal joint. Case report with literature review

    2012, Chirurgie de la Main

    Nous rapportons un cas particulier de luxation médiocarpienne radiale à déplacement antérieur survenue après une chute d’un lieu élevé et qui est caractérisée par la séparation de l’ensemble du trapèze, trapézoïde, premier, deuxième et troisième métacarpiens du restant du carpe. Nous l’avons traitée par embrochage après réduction à foyer ouvert. Avec un recul de 12mois, le résultat fonctionnel est satisfaisant avec une bonne force musculaire (force de serrage, force de préhension et pince pollicidigitale: 90% par rapport au côté controlatéral) et une récupération complète de la mobilité du poignet en flexion-extension et des doigts. Le travail a été repris à la dixième semaine. Cette luxation médiocarpienne radiale est rare. Le mécanisme de survenue ainsi que le traitement sont discutés.

    We report a case of traumatic axial disruption of the radial mid carpal joint. This unusual type of scaphotrapezo-trapezoïdal dislocation occurred after falling from a height. We performed open reduction and wire fixation. At 12months follow-up, functional outcome was satisfactory with good muscle strength (clamping force, grip strength and pinch grip: 90% compared to the opposite side) and good range of motion was preserved. Work was resumed at the tenth week. Radial midcarpal disruption is uncommon. It includes the separation of the trapezium, trapezoïdal, first and second and third metacarpal bones from the remaining wrist. This pattern of carpal derangement has not been previously described in the literature. Mechanism of the injury and treatment are discussed.

  • Current trends in nonoperative and operative treatment of trapeziometacarpal osteoarthritis: A survey of US hand surgeons

    2012, Journal of Hand Surgery

    We noted that half the hand surgeons surveyed would choose trapeziectomy/LRTI-type procedures for this problem. Rogers and Watson27 previously reported excellent outcomes for STT fusion in 20 patients with STT arthritis, and one-third of respondents chose this option. Other authors have noted generally good results for STT arthrodesis in isolated STT arthritis28; although Minami et al29 noted in a series of both Kienböck and STT arthritis that 23% of patients developed radioscaphoid arthritis with a mean follow-up of 84 months.

    Multiple procedures have been described for trapeziometacarpal (TM) osteoarthritis with varying levels of evidence support. The purpose of this study was to evaluate current trends in the treatment of TM arthritis by surveying active members of the American Society for Surgery of the Hand.

    We sent an online questionnaire to the e-mail addresses of 2,326 active members of the American Society for Surgery of the Hand, consisting of 5 treatment and 2 demographic questions. Surgeons were contacted twice by e-mail and provided with a link to a de-identified online survey. We performed statistical analysis of correlations between demographics and treatment preferences using chi-square testing.

    We received responses from 1,156 out of 2,326 hand surgeons, a response rate of 50%. The vast majority of surgeons use corticosteroid injections for TM arthritis, and 719 out of 1,156 perform trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for common Eaton stage III arthritis. For scaphotrapeziotrapezoid (STT) arthritis, approximately half of respondents also perform trapeziectomy/LRTI, followed by STT fusion. For a younger woman with minimal radiographic change and pain, 535 out of 1,142 surgeon respondents would advocate continued conservative treatment, whereas the remainder chose Eaton ligament reconstruction, arthroscopy, and metacarpal osteotomy.

    This survey study presents the current opinions of a group of hand surgeons who responded to an online questionnaire regarding treatment of TM arthritis. The results show that trapeziectomy/LRTI is the treatment of choice by most respondents. The use of trapeziectomy/LRTI in the treatment of STT arthritis has not been studied in depth, but this procedure was chosen by half the respondents. The process of choosing treatment strategies is a question for future study.

    (Video) Thumb Basal Joint / CMC Arthritis Treatment - Regenexx Orthopedic Regenerative Treatment

    Prognostic IV.

  • Scaphotrapeziotrapezoid arthrodesis for arthritis

    2005, Hand Clinics

  • A radiographic view of the scaphotrapezium-trapezoid joint

    2005, Journal of Hand Surgery

    Traditionally the scaphotrapezium-trapezoid joint is imaged through a posteroanterior view of the wrist. We describe an x-ray view that is aimed directly at the joint, which gives better visualization than the standard views.

View all citing articles on Scopus

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Copyright © 1990 Published by Elsevier Inc.

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