Tratamiento quirúrgico de la rizartrosis del pulgar mediante la técnica de Burton - Pellegrini

Resumo

Introduction: The resection and interposition arthroplasty with the tendón of flexor carpi radialis (FCR) are procedures widely applied in the treatment of rhizarthrosis thumb. Numerous variants have been published, among which is the technique described by Burton and Pellegrini in 1986, with good clinical and functional results. Material and Methods: A retrospective study of 23 resection interposition arthroplasty using the technique of Burton- Pellegrini. We analyze the mobility and function of the thumb, pain relief and the capacity for activities of daily living using Quick DASH. We evaluated the radiographic changes trapeziectomy space and changes in the metacarpophalangeal joint. It contrasts the usefulness of technical variations such as full employment and absence of tendon fixation with Kirschner wire intermetacarpal. Results: In most patients experienced significant improvement in pain (82.6% had absent or occasional pain) and oppose the thumb to the base of the 5th finger (73.91%). We did not observe clinical or radiographic instability of 1 metacarpal. Trapeziectomy space decreased from 9.8 to 4.4 mm in the monitoring, but in no case was contact between the metacarpal and scaphoid. Technical changes do not alter the clinical outcome. One patient was operated on in second half by capsulodesis Uncorrected metacarpophalangeal hyperextension. We collect a bad result for injury to the sensory branch of the median nerve. Conclusions: The procedure of Burton and Pellegrini complete using FCR tendon provides good clinical outcomes and reproducible pain relief and function of the thumb in patients with rhizarthrosis.