Trapezoid Stress Fracture in a Weight Lifter / 대한정형외과학회잡지

Trapezoid fracture is a rare condition and especially, isolated trapezoid fracture is most rare condition of carpal bone fracture. And principle of treatment has not yet been established. Most of trapezoid fractures can be treated using cast but displaced fracture or fracture combined with other carpal bone fractures may require operative treatment. There have been reports about case of conservative treatment in trapezoid stress fracture but no report about case of operative management. We treated a trapezoid stress fracture in a weight lifting athlete by operative treatment and report the results with literature review.

Trapecectomía simple artroscópica: técnica quirurgica / Simple arthroscopic trapeziectomy: surgical technique

La artrosis carpo-metacarpiana del pulgar es una patología frecuente y que produce severos déficits en las actividades de la vida diaria. Diferentes procedimientos han sido descriptos para tratar los estadíos Eaton II, III y IV. Se presenta una revisión bibliográfica que evidencia que la trapecectomía total simple aún no ha podido ser superada por otras técnicas. Se presenta nuestra técnica quirúrgica y experiencia en más de 70 pacientes operados en nuestro centro en los últimos nueve años que implica la resección total del trapecio con asistencia artroscópica. La técnica se realiza con óptica de 2,7 mm, con portales trapecio metacarpianos convencionales (IR y IU) y ayuda del intensificador de imágenes. La cirugía finaliza con vendaje blando y precozmente comienza con la rehabilitación. Se concluye que la trapecectomía simple videoasistida ofrece una técnica simple, con gran confort postoperatorio y rápido retorno a las actividades de la vida diaria.

Arthroplasty of the trapeziometacrpal joint. A study of 36 cases

This retrospective study was done during the period 1998 - 2002 to evaluate two types of surgeries for symptomatic osteoarthritis of the trapeziometacarpal joint at the base of the thumb in 36 hands. There were 19 females and 7 males. Follow up period ranged from 18 to 39 months [mean 32 months]. The study reviewed fifteen [41.7%] hands treated by tendon interposition arthroplasty with ligamentoplasty and twenty one [58.3%] hands treated by silicone replacement arthroplasty. The clinical outcome was measured depending on the assessment of pain, function, movement and strength. Radiologic follow up was done for proximal shift of the thumb metacarpal as well as signs of implant instability or wear. For this short term follow up, there was no significant difference regarding the power, movement, or function between either groups. In the tendon interposition arthroplasty group; pain relief was much better, no significant complications and the ultimate clinical score was excellent [36 points]. In the silicone replacement group; the clinical score was good [32 points] and complication rate was high with four implant dislocations [19%] and two symptomatic synovitis [9.5%]. Six hands of the silicone replacement group [28.5%] needed revision by removal of the implant while in the tendon interposition group no revision was needed

Isolated Dorsal Dislocation of the Trapezoid / 대한정형외과학회잡지

Isolated dorsal dislocation of the trapezoid is an unusual injury. In 1990 Ostroski found only 15 cases of dorsal dislocation of the trapezoid in the world literature. The trapezoid is a wedge-shaped bone with the larger dorsal and smaller volar surface area, and stabilized by strong palmar ligaments. Therefore the dislocation of the trapezoid is produced hy a violent force against the dorsum of the hand on a rigid object and often associated with other injuries of the hand. The diagnosis is often missed or delayed perhaps secondary to the difficulty in interpreting the X-ray if you have not kept in mind. Several therapeutic modalities are performed from the collected experience of the authors reporting this injury. A rare example of an isolated dorsal dislocation of the trapezoid bone is described.