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Published on: July 5, 2011
[Arthroscopic partial trapezectomy. A radio-anatomical study about 14 cases]
J Beldame1, P Desmoineaux, Y-P Le Moulec
1Service d'orthopédie traumatologique-SOS main, CHU de Rouen, 76031 Rouen cedex, France.
Chirurgie De La Main
|May 11, 2010
Summary
Arthroscopic trapezium resection for osteoarthritis is feasible, but advanced degeneration increases incomplete resection risk. Radiography can help identify resection defects but isn't ideal for assessing bone removal.
Area of Science:
- Orthopedic Surgery
- Arthroscopy
- Osteoarthritis Research
Background:
- Trapeziometacarpal osteoarthritis is a common cause of hand pain.
- Arthroscopic trapezium resection is a surgical option for managing this condition.
- Assessing the completeness of resection and the efficacy of imaging modalities is crucial.
Purpose of the Study:
- To evaluate arthroscopic trapezium surface accessibility for resection.
- To determine the impact of osteoarthritis stage on resection completeness.
- To assess the utility of X-rays in quantifying resected bone.
Main Methods:
- Fourteen arthroscopic trapezectomies were performed on cadaveric specimens.
- Pre- and post-procedure X-rays were used to assess osteoarthritis and resection.
- Dissection evaluated resection quality and anatomical relationships of surgical approaches.
Main Results:
- Arthroscopic resection provided access to the trapezium surface.
- X-rays showed complete resection in only 6 of 14 wrists.
- Incomplete resections (less than 20%) occurred in 3 wrists, particularly in advanced osteoarthritis cases.
Conclusions:
- Arthroscopic approach allows full trapezium access, but high osteoarthritis stage poses an incomplete resection risk.
- Adding an anterior portal to the posterior approach did not improve accessibility.
- Radiography is limited for assessing resected surface but aids in defect localization and guiding surgery.