Diagnostic and treatment recommendations for recurrent or persistent symptoms after trapeziectomy: a Delphi study.

The Journal of hand surgery, European volume Pub Date : 2024-11-01 Epub Date: 2024-01-31 DOI:10.1177/17531934241227386

Daniel B Herren, Michel Boeckstyns, Kevin C Chung, Simon Farnebo, Elisabet Hagert, Jin Bo Tang, Frederik Verstreken, Miriam Marks

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Abstract

The aim of this Delphi study was to provide a diagnostic and treatment algorithm for patients with persistent or recurrent symptoms after trapeziometacarpal joint resection arthroplasty. Three Delphi rounds were conducted in which surveys were sent to 182 experienced hand surgeons worldwide. Responses were received from 140 participants. A consensus threshold was set at 67% agreement. Diagnostic tools and treatment approaches for six common revision scenarios achieved consensus. Radiographs are appropriate as primary (97%) and CT scans as secondary (76%) diagnostic tools. For scaphometacarpal impingement, 67% of respondents agreed that revision interposition is appropriate, with 93% recommending autologous tendon for the interposition. Additional suspension was considered appropriate by 68% of the participants. The diagnostic and treatment algorithm can help the surgeon to identify the reason for persistent symptoms after trapeziometacarpal joint resection arthroplasty and to choose an appropriate treatment strategy.Level of evidence: V.

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梯形切除术后复发或持续症状的诊断和治疗建议：德尔菲研究。

本德尔菲研究的目的是为梯形掌关节切除关节置换术后症状持续或复发的患者提供诊断和治疗算法。本研究共进行了三轮德尔菲讨论，向全球 182 名经验丰富的手外科医生发送了调查问卷。共收到 140 位参与者的回复。共识阈值设定为 67%。针对六种常见翻修情况的诊断工具和治疗方法达成了共识。X光片可作为主要诊断工具（97%），CT扫描可作为辅助诊断工具（76%）。对于肩掌撞击，67%的受访者认为翻修插植术是合适的，93%的受访者建议使用自体肌腱进行插植。68%的受访者认为额外的悬吊术是合适的。该诊断和治疗算法可帮助外科医生确定梯形掌关节切除关节置换术后症状持续存在的原因，并选择适当的治疗策略：V.

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Journal of hand surgery, European volume

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