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KMID : 0361620090440020240
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Journal of the Korean Orthopaedic Association
2009 Volume.44 No. 2 p.240 ~ p.248
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Treatment of Subsesamoid Arthritis of the Metacarpophalangeal Joint of the Thumb: Volar Plate Reinforcing Technique after Sesamoid Excision
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Kim Jong-Pil
Yoo Hyun-Yul
Min Byoung-Kwon
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Abstract
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Purpose: To report the clinical outcomes of a volar plate reinforcing technique with free tendon grafts after sesamoid excision for the surgical treatment of subsesamoid arthritis of the metacarpophalangeal (MCP) joint of the thumb.
Materials and Methods : Eleven consecutive patients that underwent sesamoid excision and volar plate reinforcement using a palmaris longus free tendon graft were enrolled. There were 7 males and 4 females, with an average age of 46 (range, 30-56 years). Post-traumatic arthritis after a hyperextension injury of the thumb was present in 9 patients. Two patients had idiopathic arthritis. All patients were evaluated by objective and subjective criteria, the mean follow-up duration was 19 months (range, 12-35 months).
Results: The results were satisfactory overall (3 excellent, 7 good, 1 poor). The mean grip strength and pinch strength significantly improved from 63.0% and 51.3%, respectively, preoperatively, to 84.9% and 88.9%, postoperatively. The mean range of motion for the MCP joint was ?5.9/50.9 degrees. The mean DASH and MHQ scores showed significant improvement compared to the preoperative scores.
Conclusion: The early clinical results suggest that the described technique is a safe and effective option for subsesamoid arthritis of the MCP joint of the thumb.
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KEYWORD
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Thumb, Metacarpophalageal joint, Subsesamoid arthritis, Sesamoid excision, Volar plate reinforcing technique
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