[Carpal instability with scapho-lunate dissociation treated using the flexor carpi radialis and scaphoid-trapezoid ligament repair: foundations, technique and results of preliminary series].

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Abstract

[Indexed for MEDLINE] 8. Injury. 2023 Dec;54 Suppl 7:111156. doi: 10.1016/j.injury.2023.111156. Epub 2024 Jan 13. Functional survival of cementless trapeziometacarpal total joint arthroplasty after upper extremity trauma. Simón-Pérez C(1), Chavez Valladares S(2), Rodríguez-Mateos JI(3), Plata Garcia M(2), Garcia Virto V(2), Aguado HJ(4), Martín-Ferrero MA(4). Author information: (1)Discipline of Orthopaedics, University of Valladolid, Spain. Electronic address: simonclarisa@yahoo.es. (2)Department of Orthopaedics, Hospital Clínico Universitario, Valladolid, Spain. (3)Department of Plastic Surgery, Hospital Rio Hortega, Valladolid, Spain. (4)Discipline of Orthopaedics, University of Valladolid, Spain. INTRODUCTION: Our purpose with this publication is to document the survival of uncemented and unconstrained total trapeziometacarpal arthroplasty after energy trauma to the upper extremity. MATERIAL AND METHODS: From 1999 to the present, ten patients carrying total TMC arthroplasty suffered major traumatic injuries on the hand. Eight patients had fractures of the distal radius, one patient had scapho-lunate dissociation and one patient had a dorsal pullout of the triquetrum. A clinical and radiological examination of the patients after the trauma was carried out and compared with the pre-traumatic prosthesis status. RESULTS: Three patients required surgical intervention for the associated traumatic injury. The postraumatic clinical and functional follow-up of the patients was good, and no differences were documented with respect to mobility, strength and pain at the level of the thumb with respect to the prior to the trauma. No signs of loosening, instability or alteration in the alignment of the components of the protheses were observed in the radiological examinations following the trauma. CONCLUSIONS: There is a high survival rate of uncemented total trapeziometacarpal arthroplasty in the long term, even in the face of energy trauma. It is then a safe implant. Despite of being non-constrained, a good alignment of the prosthetic components is the key to avoid dislocation of the prosthesis. Copyright © 2023 Elsevier Ltd. All rights reserved. DOI: 10.1016/j.injury.2023.111156