Metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis: Relationship to first metacarpal head shape, and clinical impact.

Autor: Degeorge B; Groupe OrthoSud, Clinique Saint-Jean Sud de France, 1 Place de l'Europe, 34430 Saint Jean de Védas, France. Electronic address: degeorge.benjamin@gmail.com., Delvaque JG; Service de Chirurgie Orthopédique et Traumatologique du Membre Supérieur, Chirurgie de la Main et des Nerfs Périphériques, CHU Lapeyronie, 371 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France., Carre R; Service de Chirurgie Orthopédique et Traumatologique du Membre Supérieur, Chirurgie de la Main et des Nerfs Périphériques, CHU Lapeyronie, 371 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France., Teissier J; Groupe OrthoSud, Clinique Saint-Jean Sud de France, 1 Place de l'Europe, 34430 Saint Jean de Védas, France., Chammas M; Service de Chirurgie Orthopédique et Traumatologique du Membre Supérieur, Chirurgie de la Main et des Nerfs Périphériques, CHU Lapeyronie, 371 Avenue du Doyen Gaston Giraud, 34090 Montpellier, France.
Jazyk: angličtina
Zdroj: Hand surgery & rehabilitation [Hand Surg Rehabil] 2024 Sep; Vol. 43 (4), pp. 101725. Date of Electronic Publication: 2024 May 23.
DOI: 10.1016/j.hansur.2024.101725
Abstrakt: Purpose: The aim of this study was to determine whether the shape of the first metacarpal head influences metacarpophalangeal hyperextension, and to evaluate the influence of metacarpophalangeal hyperextension on hand pain and function in patients with trapeziometacarpal osteoarthritis.
Methods: 362 patients with painful basal thumb osteoarthritis were evaluated over a 2-year period. Pain rating on a visual analog scale, trapeziometacarpal and metacarpophalangeal motion, and grip and pinch strength were evaluated. The shape of the metacarpal head was assessed on strict lateral radiographs using the "A/r" ratio.
Results: Round metacarpal heads had significantly greater and more frequent metacarpophalangeal hyperextension than flat heads (28° vs. 8°, and 78% vs. 29%). Metacarpophalangeal hyperextension adversely impacted trapeziometacarpal motion in antepulsion (27° vs. 32°), abduction (25° vs. 30°) and pinch strength (3.6 vs. 4.6 KgF).
Conclusion: Our findings indicate that the shape of the metacarpal head influences metacarpophalangeal hyperextension in trapeziometacarpal osteoarthritis. Metacarpophalangeal hyperextension adversely impacted pinch strength and trapeziometacarpal motion.
Level of Evidence: Level IV, Retrospective case series.
(Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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