RESUMO
Trapeziometacarpal prosthesis by metallic implant is used to treat thumb carpometacarpal osteoarthritis. Many causes of failure have been described whereas revision techniques still remain a challenging surgery. In this article, we describe a revision strategy in a failed metallic cemented trapeziometacarpal implant with major first metacarpal shortening.
Assuntos
Prótese Articular , Ossos Metacarpais/cirurgia , Osteoartrite/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Polegar/cirurgia , Trapézio/cirurgia , Idoso , Fios Ortopédicos , Avaliação da Deficiência , Humanos , Metais , Pessoa de Meia-Idade , Desenho de Prótese , Falha de Prótese , Amplitude de Movimento Articular , Reoperação , Resultado do TratamentoRESUMO
The free vascularised corticoperiosteal flap from the medial femoral condyle, as described by Doi and Sakai, can be used for difficult non-unions. This flap is supplied by the Descending Genicular Artery (DGA) and the Superomedial Genicular Artery (SMA). In this anatomical study we describe the anatomy of these arteries. The DGA was dominant in 24 of 34 cases (70%). If the DGA was absent or too small, the SMA was sufficiently large for an adequate supply of the graft area. We concluded that of all the dissected specimens the arteries were sufficiently large and long enough to be suited for microsvascular anastomosis.