MOJ ISSN: 2374-6939MOJOR

Orthopedics & Rheumatology
Mini Review
Volume 3 Issue 4 - 2015
Surgical Treatment of the First Carpometacarpal Joint Arthritis Using a Mini External Fixation System
Athanasios Alexandris*, Georgios Varsanis, Nikolaos Tassios, Maria Sfakiotaki and Vaios Goulas
Department of Orthopedics, General Hospital of Trikala, Greece
Received: October 14, 2015 | Published: October 27, 2015
*Corresponding author: Athanasios Alexandris, Department of Orthopedics, General Hospital of Trikala, Karditsis 51 Trikala 42100, Greece, Tel: 00306947445950; Email:
Citation: Alexandris A, Varsanis G, Tassios N, Sfakiotaki M, Goulas V (2015) Surgical Treatment of the First Carpometacarpal Joint Arthritis Using a Mini External Fixation System. MOJ Orthop Rheumatol 3(4): 00101. DOI: 10.15406/mojor.2015.03.00101

Purpose

Evaluation of our primary results from the use of a mini ex-fix system for the treatment of the first carpometacarpal joint arthritis [1-3] (Figure1).

Method

We admitted in our clinic 10 patients the last 2 years. 7 females, 3 males, all of them were agriculture workers. The main age 62 was years old (55-72y).
All the patients complained for pain and tenderness to the base of the thumb more than 3 years and presented decrease grip strength [4].
In all the patients the anaesthesia was axillary block.
After an open debridement of the first carpometacarpal joint (Figure 2) we apply, under x-ray control, a mini ex-fix system [3,5] (Figure 3).
It’s very important the application of the first needle of the system to cause compression between the base of the first metacarpal and the trapezium (Figure 4 & 5) [6-10].

Results

In all the patients the system was removed after six weeks in outpatient clinic.
One patient had a pin track infection which was treated by oral antibiotics.
The post-op evaluation of the patients includes clinical examination and x-ray control.
All the patients had a short course of physical therapy post-op [11-16].
All the patients had complete pain relief and most of them returned to their previous activity after 3 months postoperative [17-18].

Figure 1: Mini ex-fix system for the treatment of the first carpometacarpal joint arthritis.

Figure 2: After an open debridement of the first carpometacarpal joint.

Figure 3: Under x-ray control, a mini ex-fix system.

Figure 4: Under x-ray control, a mini ex-fix system.

Figure 5: Under x-ray control, a mini ex-fix system.

Conclusion

Even that the number of the patients and the follow up is short we believe that the above method is a safe and rigid method with satisfactory results (Figure 6) [19,20].

Figure 6: After treatment.

References

  1. Beckmann J, Rader C, Lüring C, Rath B, Grifka J, et al. (2010) Endoprothetische Gelenkversorgung bei Hüftkopfnekrose. Osteologie 47-52.
  2. Beckmann J, Tingart M, Perlick L, Lüring C, Grifka J, et al. (2007) Navigierte Anbohrung der Femurkopfnekrose. Der Orthopäd 36(5): 458-465.
  3. Tang TT, Lu B, Yue B, Xie XH, Xie YZ, et al. (2008) Treatment of osteonecrosis of the femoral head with hBMP-2-gene-modified tissue-engineered bone in goats. J Bone Joint Surg Br 89(1): 127-129.
  4. Nickel F, Maierhöfner C (2010) aktuelle Erkenntnisse zur Pathophysiologie des CRPS I. Handchir Mikrochir Plast Chir 42(1): 8-14.
  5. Lieberman J, Berry D, Montv M, Aaron R, Callaghan, et al. (2002) Osteonecrosis of the Hip: Management in the Twenty-first Century. Instr Course Lect 52: 337-355.
  6. Ficat R (1985) Idiopathic Bone Necrosis of the Femoral Head. J Bone Joint Surg B 67(1): 3-9.
  7. von Stechow D, Drees P (2007) Operative Therapiekonzepte der Hüftkopfnekrose. Der Orthopäde 36(5): 451-457.
  8. Aigner N, Petje G, Schneider W, Meizer R, Wlk M, et al. (2005) Bone marrow edema syndrome of the femoral head: treatment with the prostacyclin analogue iloprost vs. Core decompression: an MRI-controlles study. Wien Klin Wochenschr 117(4): 130-135.
  9. Symptomatic multifocal osteonecrosis. A multicenter study. Collaborative Osteonecrosis Group. (1999) Clin Orthop Relat Res 369: 312-326.
  10. Guerra JJ, Steinberg ME (1995) Distinguishing Transient Osteoporosis from Avascular Necrosis of the Hip. J Bone Joint Surg Am 77(4): 616-624.
  11. Min Hong J, Kim TH, Chae SC, Koo KH, Jong Y, et al. (2007) Kim S.-Y. Association study of hypoxia inducible factor 1 Alpha (HIF1Alpha) with osteonecrosis of femoral head in a Korean population. OsteoArthritis and Cartilage 15(6): 688-694.
  12. Zirong Li (2005) Scientific diagnosis and treatment of femoral head necrosis. Chinese J Reparative and Reconstructive Surgery 19(9): 685-686.
  13. Lieberman J, Conduah A, Urist M (2004) Treatment of Osteonecrosis of the Femoral Head with Core Decompression and Human Bone Morphogenetic Protein. Clin Orthop Relat Res 429: 139-145.
  14. Petrigliano F, Lieberman J (2007) Osteonecrosis of the hip: novel approaches to evaluation and treatment. Clin Orthop Relat Res 465: 53-62.
  15. Yamamoto T, Irisa T, Sugioka Y, Sueishi K (1997) Effects of pulse methylprednisolone on bone and marrow tissues: corticosteroid-induced osteonecrosis in rabbits. Arthritis Rheum 40(11): 2055-2064.
  16. Intema F, DeGroot J, Elshof B, Vianen ME, Yocum S, et al. (2008)The canine bilateral groove model of osteoarthritis. J Orthop Res 26(11): 1471-147.
  17. Atsumi T, Kuroki Y, Yamano K, Muraki M (1996) Revascularization in Nontraumatic Osteonecrosis of the Femoral Head. Clin Orthop Relat Res 325: 168-173.
  18. Sevitt S, Thompson R (1965) The Distribution and Anastomoses of Arteries supplying the Head and Neck of the Femur. J Bone Joint Surg Br 47: 560-573.
  19. Straub R, Cutolo M (2001) Involvement of the hypothalamic--pituitary-- adrenal/gonadal axis and the peripheral nervous system in rheumatoid arthritis: viewpoint based on a systemic pathogenetic role. Arthritis Rheum 44(3): 493-507.
  20. Straub R, Wiest R, Strauch U, Härle P, Schölmerich J (2006) The role of the sympathetic nervous system in intestinal inflammation. Gut 55(11): 1640-1649.
  21. Straub R, Günzler C, Miller L, Cutolo M, Schölmerich J, et al. (2002) Anti- inflammatory cooperativity of corticosteroids and norepinephrine in rheumatoid arthritis synovial tissue in vivo and in vitro. The FASEB J 16(9): 993-1000.
  22. Drescher W, Li H, Lundgaard A, Bünger C, Hansen E (2006) Endothelin-1- induced Femoral Head Epiphyseal Artery Constriction is Enhanced by Long- Term Corticosteroid Treatment. J Bone Joint Surg Am 88 (Suppl 3): 173-179.
  23. Drescher W, Varoga D, Liebs T, Lohse J, Herdegen T, et al. (2006) Femoral Artery Constriction by Norepinephrine Is Enhanced by Methylprednisolon in a Rat Model, J Bone Joint Surg Am 88 Suppl 3: 162-166.
© 2014-2016 MedCrave Group, All rights reserved. No part of this content may be reproduced or transmitted in any form or by any means as per the standard guidelines of fair use.
Creative Commons License Open Access by MedCrave Group is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://medcraveonline.com
Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version | Opera |Privacy Policy