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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Total Thumb Trapeziometacarpal Joint Arthroplasty: A Retrospective Study of 12 Prostheses Implanted with WALANT Technique

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  • presenting/speaker Camillo Theo Muller - CHUV, Centre de la Main, Lausanne, Switzerland
  • Olivier Deboccard - CHUV, Lausanne, Switzerland
  • Thierry Christen - CHUV, Lausanne, Switzerland
  • Sébastien Durand - CHUV, Lausanne, Switzerland
  • Wassim Raffoul - CHUV, Lausanne, Switzerland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-570

doi: 10.3205/19ifssh0203, urn:nbn:de:0183-19ifssh02033

Published: February 6, 2020

© 2020 Muller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: De la Caffinière first described total trapeziometacarpal joint prosthesis in 1974 for treatment of the first carpometacarpal joint arthritis. Even though this technique is more expensive than trapeziectomy, it has some advantages such as faster convalescence. Since we perform this procedure under WALANT technique, we report the perioperative and early postoperative functional results of patients treated with a thumb carpometacarpal joint prosthesis implantation in WALANT technique to consider the use of local anesthesia for thumb arthritis surgery.

Methods: A retrospective study assessed perioperative pain score and functional results of 12 patients treated for trapeziometacarpal advanced osteoarthritis (Eaton and Littler stage III). Pre-, peri- and postoperative assessments included pain, range of motion, and pinch and grip strength. The average follow-up time was 12 months.

Results and Conclusions: The mean pain score measured by a visual analog scale was 8 preoperatively, 2 perioperative and 1 postoperatively. The mean preoperative Kapandji opposition score was 7 and postoperative score were 10. The grip strength improved from 17 kg before to 23 kg after surgery.

Trapeziometacarpal arthroplasty with a joint prosthesis in WALANT appears to be a feasible. Patients suffered minimal intraoperative pain and comparable early functional outcomes to other type of anesthesia. The low perioperative pain score and the good early functional outcome encourages us to recommend this treatment of severe trapeziometacarpal osteoarthritis.