Cartilage graft from rib to treat trapeziometacarpal arthritis.
Fiche publication
Date publication
janvier 2021
Journal
Hand surgery & rehabilitation
Auteurs
Membres identifiés du Cancéropôle Est :
Dr GINDRAUX Florelle
Tous les auteurs :
Pluvy I, Lepage D, Haight H, Echallier C, Menu G, Vidal C, Gindraux F, Gallinet D, Adam A, Aubry S, Obert L, Ferreira D, Tropet Y, Loisel F
Lien Pubmed
Résumé
Trapeziectomy has been considered as the gold standard for treating trapeziometacarpal arthritis. But trapezial space collapse is responsible for thumb strength decrease and intracarpal deformities (with or without tendon interposition). Partial trapeziectomy with interposition of a chondrocostal autograft combines the advantages of trapeziectomy and a biological spacer without the disadvantages of arthroplasty. Partial trapeziectomy is performed by a dorsal approach, under regional anaesthesia. The graft is harvested by a direct approach of the 9 rib during a short bout of general anaesthesia and inserted in the trapeziectomy space. A thumb spica cast is used for 3 to 6 weeks. In our experience, long-term outcomes and radiological evolution of the graft are good, similar to that of other procedures reported in the literature, except for strength, which is better in this scenario. With more than 5 years of follow-up, the graft is viable, the length of the thumb is maintained, and any areas of graft metaplasia are localized. The result is stable over time and any donor site morbidity is anecdotal. The interposition of a biological material is feasible and produces a stable and strong thumb.
Mots clés
Cartilage graft, Greffe de cartilage costal, Partial trapeziectomy, Rhizarthrose, Rib, Trapezectomie partielle, Trapeziometacarpal arthritis
Référence
Hand Surg Rehabil. 2021 Jan 14;: