Partial Denervation of the Thumb Carpometacarpal Joint: A New Technique.

IF 1.8 Q2 ORTHOPEDICS
HAND Pub Date : 2025-03-01 Epub Date: 2023-10-27 DOI:10.1177/15589447231200646
Hayman Lui, Sanjeev Kakar
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引用次数: 0

Abstract

Background: To report the clinical outcomes of partial denervation for the treatment of basilar thumb joint arthritis.

Methods: Patients who underwent partial denervation of the basilar thumb joint for osteoarthritis from a single center between 2019 and 2021 were recruited into the study. This involved a technique that involved cauterization of the joint capsule and its innervation through the branches of the superficial radial, palmar cutaneous branch of the median, lateral antebrachial, and ulnar nerves. Patients were followed up postoperatively to record clinical (grip strength, thumb apposition and opposition pinch grip strength, Kapandji score) and patient-reported outcomes (visual analogue scale [VAS], Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH], Patient-reported Wrist Evaluation [PRWE]).

Results: Twelve patients (15 carpometacarpal joints; 9 female and 3 male patients) underwent a partial denervation of the thumb (Eaton stage 3-4). The mean age at the time of surgery was 63 ± 5 years (range 56-72). The mean clinical follow-up duration was 23 ± 11 months (range 9-42 months), and functional score follow-up duration was 27 ± 7 months (range 14-42 months). At the latest clinical follow, VAS score, Kapandji score, grip strength, and thumb apposition/opposition pinch strength all improved significantly (P < .05). The mean QuickDASH score was 30 ± 16, and PRWE score was 32 ± 17. Patients who had unilateral partial thumb denervation demonstrated greater improvement in grip strength than patients who had bilateral partial thumb denervation procedures (P = .01).

Conclusion: In this clinical case series, our method of basilar thumb joint partial denervation has been effective in improving clinical outcomes and reducing pain due to osteoarthritis.

Level of evidence: IV, case series.

拇指-腕足跖关节部分失神经:一项新技术。
背景:报告部分去神经支配治疗拇指基底关节炎的临床疗效。方法:2019年至2021年间,在一个中心接受拇指基底关节部分去神经支配治疗骨关节炎的患者被纳入研究。这涉及一种技术,包括烧灼关节囊及其通过正中桡浅支、掌侧皮支、前臂外侧神经和尺骨神经分支的神经支配。术后对患者进行随访,记录临床(握力、拇指贴附和对手捏握力、Kapandji评分)和患者报告的结果(视觉模拟评分[VAS]、手臂、肩膀和手部快速残疾[QuickDASH]、患者报告的手腕评估[PRWE])。结果:12名患者(15个腕掌关节;9名女性和3名男性患者)接受了拇指部分去神经支配(Eaton 3-4期)。手术时的平均年龄为63±5岁(范围56-72)。平均临床随访时间为23±11个月(9-42个月),功能评分随访时间为27±7个月(14-42个月。在最近的临床随访中,VAS评分、Kapandji评分、握力和拇指贴附/相对捏力均显著改善(P<0.05)。平均QuickDASH评分为30±16,PRWE评分为32±17。单侧拇指部分去神经支配的患者比双侧拇指部分去神经元支配的患者在握力方面表现出更大的改善(P=.01)。结论:在本临床病例系列中,我们的拇指基底关节部分去神经方法在改善临床结果和减轻骨关节炎引起的疼痛方面是有效的。证据级别:四、系列案件。
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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来源期刊
HAND
HAND Medicine-Surgery
CiteScore
3.30
自引率
0.00%
发文量
209
期刊介绍: HAND is the official journal of the American Association for Hand Surgery and is a peer-reviewed journal featuring articles written by clinicians worldwide presenting current research and clinical work in the field of hand surgery. It features articles related to all aspects of hand and upper extremity surgery and the post operative care and rehabilitation of the hand.
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