Resumo

NEVES, João et al. Artroplastia de interposição tendinosa no tratamento da rizartrose pela modificação da técnica Burton-Pellegrini. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.4, pp.487-501. ISSN 1646-2122.

Introduction: the rizartrose is a common clinical entity in women, there are several options described for the surgical treatment. Objectives: the authors have done this study in order to retrospectively assess the functional outcome of a series of patients undergoing surgical treatment of rizartrose by the technique of Burton modified by Fachada - resection of the trapezium associated with interposition an anchovy half of the flexor carpi radialis tendon to anchor the base of the first metacarpal. Methods: from January 2008 to March 2013 were submitted to surgical treatment of the Rizartrose by this technique modification 42 patients (39 women and 3 men), comprising a total of 47 thumbs. The average age of patients was 64.79 years, between 48 and 83 years. The study included patients with osteoarthritis of the trapezium-metacarpal joint in stages II, III and IV of Eaton-Littler, persistent pain refractory to conservative treatment. The mean follow up time is around 26.55 months (minimum of 4 months and maximum 62 months). For functional assessment was used visual analogue scale, QuickDASH questionnaire and score Buck-Gramcko. In patient global assessment were evaluated grip strength, pinch pulp pulp, lateral pinch, opponency and radial and palmar abduction. Evaluation of the migration rate of the first metacarpal. Results: applying the Buck-Gramcko score had verified that the ost of the patients in the sample (76,2%) considered the surgical results "Good" or "Excellent", with a mean score of 19.21 for Quick DASH (9.1 to 38.6). The results were considered good for pain relief (p < 0.0001). In all patients registered migration of the first metacarpal with the technique of interposition, but without functional consequences. As complications we recorded most relevant: one case of algoneurodystrophy, transient paresthesias in the territory of radial sensory nerve in 3 patients and 7 cases of residual pain at the level of the trapezoid. Conclusions: trapeziectomy associated with interposition of an “anchovy" of hemitendon of the flexor carpi radialis is a simple technique that consists in a simplification of classical technique described by Burton, with less surgical time and less bone and tendinous fragility. Was effective in pain relief and providing a functional improvement. Thus, there is another efficient method in the surgical treatment of rizharthrose.

Palavras-chave : Rhizhartrose; thumb; articulation TMC; interposition arthroplasty.

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