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Utilité et complications des voies d’abord thénarienne et standard dans la chirurgie arthroscopique de la carpo-métacarpienne du pouce
Revue de chirurgie orthopédique et traumatologique 101 (2015) 488
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Mémoire original
Utilité et complications des voies d’abord thénarienne et standard dans la chirurgie arthroscopique de la carpo-métacarpienne du pouce夽 Usefulness and complications associated with thenar and standard portals during arthroscopic surgery of thumb carpometacarpal joint M. Tsujii a,∗ , R. Iida b , H. Satonaka a , A. Sudo a a b
Department of orthopaedic surgery, graduate school of medicine, Mie University, 2-174 Edobashi, Tsu City, Japon Department of orthopaedic surgery, Nagai hospital, Nagai, Japan
i n f o
a r t i c l e
Historique de l’article : ´ 2015 Rec¸u le 12 fevrier Accepté le 27 avril 2015 Keywords: Thumb carpometacarpal joint Arthroscopy Thenar portal Nerve injury
a b s t r a c t Purpose. – Advances in small arthroscopy have enabled a minimally invasive surgery for thumb carpometacarpal joints. However, surgery is often difficult using standard CM-radial (CM-R) and CM-ulnar portals (CM-U). Here, we describe the clinical applications and complications associated with using thenar portal (TP) and standard portals. Methods. – Arthroscopic surgeries of thumb carpometacarpal joint were performed in twenty-one patients including fifteen patients with osteoarthritis and six Bennett’s fracture-dislocations. Complications and the frequency of use associated with each portal were evaluated. Results. – Complications associated with the CM-R portal comprised paresthesia due to damage of the radial nerve branches in two patients. No nerves were damaged but the operation scar became tender at the TP in three patients. The CM-R was used at a lower frequency when the TP was utilized. Conclusion. – The clinical use of TP may decrease the risk of radial sensory nerve damage through decreasing frequency of use of the CM-R that is located near the nerve. Level of study. – IV. © 2015 Elsevier Masson SAS. All rights reserved.
DOI de l’article original : http://dx.doi.org/10.1016/j.otsr.2015.04.009. 夽 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. ∗ Auteur correspondant. Adresse e-mail : [email protected] (M. Tsujii). http://dx.doi.org/10.1016/j.rcot.2015.06.004 1877-0517/© 2015 Elsevier Masson SAS. Tous droits réservés.
Disponible en ligne sur
ScienceDirect www.sciencedirect.com
Mémoire original
Utilité et complications des voies d’abord thénarienne et standard dans la chirurgie arthroscopique de la carpo-métacarpienne du pouce夽 Usefulness and complications associated with thenar and standard portals during arthroscopic surgery of thumb carpometacarpal joint M. Tsujii a,∗ , R. Iida b , H. Satonaka a , A. Sudo a a b
Department of orthopaedic surgery, graduate school of medicine, Mie University, 2-174 Edobashi, Tsu City, Japon Department of orthopaedic surgery, Nagai hospital, Nagai, Japan
i n f o
a r t i c l e
Historique de l’article : ´ 2015 Rec¸u le 12 fevrier Accepté le 27 avril 2015 Keywords: Thumb carpometacarpal joint Arthroscopy Thenar portal Nerve injury
a b s t r a c t Purpose. – Advances in small arthroscopy have enabled a minimally invasive surgery for thumb carpometacarpal joints. However, surgery is often difficult using standard CM-radial (CM-R) and CM-ulnar portals (CM-U). Here, we describe the clinical applications and complications associated with using thenar portal (TP) and standard portals. Methods. – Arthroscopic surgeries of thumb carpometacarpal joint were performed in twenty-one patients including fifteen patients with osteoarthritis and six Bennett’s fracture-dislocations. Complications and the frequency of use associated with each portal were evaluated. Results. – Complications associated with the CM-R portal comprised paresthesia due to damage of the radial nerve branches in two patients. No nerves were damaged but the operation scar became tender at the TP in three patients. The CM-R was used at a lower frequency when the TP was utilized. Conclusion. – The clinical use of TP may decrease the risk of radial sensory nerve damage through decreasing frequency of use of the CM-R that is located near the nerve. Level of study. – IV. © 2015 Elsevier Masson SAS. All rights reserved.
DOI de l’article original : http://dx.doi.org/10.1016/j.otsr.2015.04.009. 夽 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. ∗ Auteur correspondant. Adresse e-mail : [email protected] (M. Tsujii). http://dx.doi.org/10.1016/j.rcot.2015.06.004 1877-0517/© 2015 Elsevier Masson SAS. Tous droits réservés.