Journal article

Publication year: 2015

Pages: 17-23

Journal: Handchirurgie, Mikrochirurgie, Plastische Chirurgie

Volume number: 47

Issue number: 1

ISSN: 0722-1819

eISSN: 1439-3980

Open access status: Bronze

DOI Link: https://doi.org/10.1055/s-0034-1398608

Publisher: Georg Thieme Verlag

Abstract: 

Aim: The aim of the current study was to review the significance of the TightRope((R)) to suspend the first metacarpal in the case of a revision for patients with painful proximalisation after trapezectomy.

Patients and Method: After an average of 25.5 months (13-60) from initial operative treatment for rhizarthrosis, revision surgery was performed on 6 female patients with a mean age of 56 years, using a Mini TightRope((R)). Before and after revision-surgery the pain level was measured, using the visual analogue scale (1-10) as was the level of strength in the fingertips. The overall result was documented according to the evaluation scale according to Buck-Gramcko. Directly after surgery as well as at the last follow-up exam, the degree of proximalisation of the first metacarpal was radiologically measured. The follow-up period was 13.7 months on average (4-31 months).

Results: After revision surgery a decrease in pain level was detected, but no patient was completely pain-free. According to the visual analogue scale the pain level after surgery compared to preoperatively was: at rest at an average of 2.5 (1-4), preoperatively 3.3 (2-4); with mild load 3.5 (2-5), preoperatively 4.8 (4-6); and with high load 4.8 (3-7), preoperatively 7 (6-8). The level of strength in the fingertips was postoperatively measured at below 60% in 2 patients (preoperatively 5 patients), once between 60 and 79% (preoperatively 1 patient) and 3 times between 80 and 99%. With an average preoperative score of 11.7 (6-16) points according to Buck-Gramcko, an increase of 20.3 points could be achieved by performing the revision operation. This resulted in a score of 32 (14-44) out of 56 points. The measured distance between the distal scaphoid pole and the centre of the base of the first metacarpal was postoperatively at an average of 8.3mm (5.6-11.4mm). The final follow-up shows an average distance of 3.3mm (2.8-4.3mm). This is consistent with an average proximalisation of 5mm. The Mini TightRope((R)) had to be removed three times. An additional operation had to be performed twice.

Conclusion: The use of the Mini TightRope((R)) for a suspension of the first metacarpal, in cases of a painful proximalisation after trapezectomy is a procedure that can cause an improvement for a certain percentage of patients. But a further proximalisation cannot be prevented by the use of the Mini TightRope((R)).

Harvard Citation style: Szalay, G., Scheufens, T., Alt, V., Thormann, U. and Heiss, C. (2015) Primary results Using the Mini TightRope® for Revision Surgery for Painful Proximalisation of the first Metacarpal after Trapezectomy for CMC-1-osteoarthritis, Handchirurgie, Mikrochirurgie, Plastische Chirurgie, 47(1), pp. 17-23. https://doi.org/10.1055/s-0034-1398608

APA Citation style: Szalay, G., Scheufens, T., Alt, V., Thormann, U., & Heiss, C. (2015). Primary results Using the Mini TightRope® for Revision Surgery for Painful Proximalisation of the first Metacarpal after Trapezectomy for CMC-1-osteoarthritis. Handchirurgie, Mikrochirurgie, Plastische Chirurgie. 47(1), 17-23. https://doi.org/10.1055/s-0034-1398608