418:
276:
322:
378:
443:
165:
37:
390:
Some physicians believe that combining LR with TI will help maintain gap between the metacarpal and the scaphoid. And that doing so will improve comfort and capability. Keep in mind that these aspects of the rationale are not supported by experimental evidence. The evidence suggests that all of these
329:
In one randomized trial comparing trapeziectomy alone with trapeziectomy with ligament reconstruction and trapeziectomy with ligament reconstruction and tendon interposition, patients evaluated 5 to 18 years after surgery had similar pain intensity, grip strength and key and tip pinch strengths after
502:
CMC OA is the most common form of OA affecting the hand. Dahaghin et al. showed that about 15% of women and 7% of men between 50 and 60 years of age develop CMC OA of the thumb. However, in about 65% of people older than 55 years, radiologic evidence of OA was present without any symptoms. Armstrong
338:
During trapeziectomy, the trapezium bone is removed without any further surgical adjustments. The trapezium bone is removed through an approximately three centimeter long incision along the lateral side of the thumb. To preserve surrounding structures, the trapezium bone is removed "by splitting" it
314:
fuses the TMC joint. It is uncommonly used. Arthroplasty surgery for TMC OA removes part or all of the trapezium. Surgery may also support the metacarpal by reconstructing a ligament using a tendon graft or weave. Surgery may also place something in the space where the trapeziometacarpal joint
354:
Some physicians still believe that it is better to fill the gap left by the trapeziectomy. They assume that filling the gap with a part of a tendon is preferable in terms of function, stability and position of the thumb. This is based on the assumption that interposition can help maintain the space
105:
There may be enlargement at the TMC joint. This area may be tender, meaning it is painful when pressed. There may also be hyperextension of the metacarpophalangeal joint. The thumb metacarpal deviates towards the middle of the hand (adduction). Also a grinding sound, known as crepitus, can be heard
93:
The main symptom is pain, particularly with gripping and pinching. This pain is often described as weakness, but true weakness is not a part of this disease. People may also note a change in shape of the thumb. Some people choose surgery, but most people find they can accommodate trapeziometacarpal
370:
Another technique is used to reconstruct the volar beak ligament after trapeziectomy. The rationale is that ligament reconstruction(LR) helps maintain the gap between the metacarpal and the scaphoid, and that a larger gap is associated with greater comfort and capability. Again these possibilities
114:
TMC OA is an expected part of aging in men and women equally. A population-based study of radiographic signs of pathophysiology in 3595 people assessed in a research-related comprehensive health examination found no association with physical workload. A study of people seeing a hand specialist for
303:
There are no treatments proved to slow or relieve TMC OA. In other words, there are no disease-modifying treatments. All treatments are symptom alleviating (palliative). Most surgery is reconstructive—it removes the TMC joint. Metacarpal osteotomy was proposed as a potentially disease
118:
Studies that compare people presenting with TMC symptoms to people without symptoms are sometimes interpreted as indicating that activities can contribute to the development of TMC OA. A more accurate conclusion may be that hand use is associated with seeking care for symptoms related to TMC OA.
455:
The aim of metacarpal osteotomy is to change the pressure distribution on the TMC joint. The hope is that this will slow the pace of development of osteoarthritis. There is no evidence that this procedure can modify the natural course of TMC OA. Osteotomy may be considered for people with mild
435:
Overall, joint replacements are related to long-term complications such as subluxation, fractures, synovitis (due to the material used) and nerve damaging. In many cases revision surgery is needed to either remove or repair the prosthesis. Also note that usage of a joint replacement is heavy in
470:
The most common complication after surgery is pain persisting in the thumb. Over long term, there is pain relief, but on short term, patients experience pain from the surgery itself. The main complaint is a burning sensation or hypersensitivity over the incision. Some patients develop a
85:
with age. Osteoarthritis is age-related loss of the smooth surface of the bone where it moves against another bone (cartilage of the joint). In reaction to the loss of cartilage, the bones thicken at the joint surface, resulting in subchondral sclerosis. Also, bony outgrowths, called
503:
et al. reported a prevalence of 33% in postmenopausal women, of which one-third was symptomatic, compared to 11% in men older than 55 years. This shows CMC OA of the thumb is significantly more prevalent in women, especially in postmenopausal women, compared to men.
1721:
Gangopadhyay S, McKenna H, Burke FD, Davis TR (March 2012). "Five- to 18-year follow-up for treatment of trapeziometacarpal osteoarthritis: a prospective comparison of excision, tendon interposition, and ligament reconstruction and tendon interposition".
294:
A simpler classification is no arthritis, some arthritis, and severe arthritis. This simpler classification system omits the potentially contradictory details of the Eaton/Littler classification and keeps scaphotrapezial arthrosis separate.
307:
There is limited and limited quality evidence regarding splints, corticosteroid injections, manual therapy and other palliative measures. Studies with adequate randomization, blinding, and independent assessment are lacking.
177:
TMC OA is diagnosed based on symptoms and signs. Radiographs can confirm the diagnosis and the severity of TMC OA. Other diagnoses in this region include scaphotrapezial trapezoid arthritis and first dorsal compartment tendinopathy
491:. Both are painful and need revision surgery so the prosthesis can be repaired or removed. When using a prosthesis over a longer period of time, there is a chance of breaking the prosthesis itself. This is due to mechanical wear.
358:
During trapeziectomy with TI, a longitudinal strip of the palmaris longus tendon is collected. If this tendon is absent (which is the case in 13% of the population), half of the flexor carpi radialis tendon (FCR) can be used.
425:
The joint can be replaced with artificial material. An artificial joint is also referred to as a prosthesis. Prostheses are more problematic at the trapeziometacarpal joint compared to joints like the knee or the hips.
1881:
Mureau MA, Rademaker RP, Verhaar JA, Hovius SE (September 2001). "Tendon interposition arthroplasty versus arthrodesis for the treatment of trapeziometacarpal arthritis: a retrospective comparative follow-up study".
402:
of the TMC joint is a surgical procedure in which the trapezium bone and the metacarpal bone of the thumb are secured together. They are held together by K-wires or a plate and screws until the bone will heal.
1620:
Vermeulen, Guus M.; Slijper, Harm; Feitz, Reinier; Hovius, Steven E.R.; Moojen, Thybout M.; Selles, Ruud W. (2011). "Surgical
Management of Primary Thumb Carpometacarpal Osteoarthritis: A Systematic Review".
160:
The TMC joint is stabilized by 16 ligaments. Of these ligaments, the deep anterior oblique ligament, also known as the palmar beak ligament, is considered to be the most important stabilizing ligament.
127:
The TMC joint is a synovial joint between the trapezium bone of the wrist and the metacarpal bone at the base of the thumb. This joint is a so-called saddle joint (articulatio sellaris), unlike the
459:
During osteotomy, the metacarpal is cut and a wedge shape bone fragment is removed to move the bone away from the hand. Postoperative, the thumb of the patient is immobilized using a thumb-cast.
406:
Disadvantages include inability to flatten the hand. Additionally, the stress on the CMC joint is now spread over the adjacent joints, those joints are more likely to develop osteoarthritis.
374:
During this procedure the anterior oblique ligament is reconstructed using the FCR tendon. There is a wide variety in techniques to perform this LR, but they all have a similar goal.
102:
The symptom that brings people with TMC OA to the doctor is pain. Pain is typically experienced with gripping and pinching. People experiencing pain may describe it as weakness.
1846:
Burton RI, Pellegrini VD (May 1986). "Surgical management of basal joint arthritis of the thumb. Part II. Ligament reconstruction with tendon interposition arthroplasty".
885:
Haara, Mikko M.; Heliövaara, Markku; Kröger, Heikki; Arokoski, Jari P. A.; Manninen, Pirjo; Kärkkäinen, Alpo; Knekt, Paul; Impivaara, Olli; Aromaa, Arpo (July 2004).
1363:
Tomaino, M. M. Thumb basal joint arthritis. In D. P. Green et al. (Eds.), Green's
Operative Hand Surgery, 5th Ed. New York: Churchill Livingstone, 2005. Pp. 461–485.
1288:
Bettinger PC, Linscheid RL, Berger RA, Cooney WP, Kai-Nan A (1999). "An anatomic study of the stabilizing ligaments of the trapezium and trapeziometacarpal joint".
637:"Osteoarthritis of the trapeziometacarpal joint: the pathophysiology of articular cartilage degeneration. II. Articular wear patterns in the osteoarthritic joint"
355:
between the metacarpal and the scaphoid, which will improve comfort and capability. Neither of these assumptions is supported by experimental evidence.
119:
Ligamentous laxity is often associated with TMC OA, but this is based on rationale rather than experimental evidence. Obesity may be related to TMC OA.
462:
Possible complications are non-union of the bone, persistent pain related to unrecognized CMC or pantrapezial disease and radial sensory nerve injury.
487:
of a prosthesis is a complication where the prosthesis is mobile and is partially dislocated. When the prosthesis is fully dislocated it is called a
1221:
Doerschuk SH, Hicks DG, Chinchilli VM, Pellegrini VD (May 1999). "Histopathology of the palmar beak ligament in trapeziometacarpal osteoarthritis".
30:
Carpometacarpal (CMC) osteoarthritis (OA) of the thumb, osteoarthritis at the base of the thumb, basilar (or basal) joint arthritis, rhizarthrosis
1503:"Survival and Long-Term Outcomes of Thumb Metacarpal Extension Osteotomy for Symptomatic Carpometacarpal Laxity and Early Basal Joint Arthritis"
1047:
Ghavami A, Oishi SN (May 2006). "Thumb trapeziometacarpal arthritis: treatment with ligament reconstruction tendon interposition arthroplasty".
409:
Nevertheless, this procedure can be used in patients with stage II and III CMC OA as well as in young people with posttraumatic osteoarthritis.
346:. Despite this gap, no significant changes in function of the thumb are reported. After the surgery, the thumb will be immobilized with a cast.
439:
The quality of the prostheses is improving and there is reason to believe this will have a positive effect on outcome in the years to follow.
2083:
Armstrong AL, Hunter JB, Davis TRC (1994). "The prevalence of reparative arthritis of the base of the thumb in post-menopausal women".
494:
Prostheses might also cause a reaction of the body against the artificial material they are made of, resulting in local inflammation.
481:
After arthrodesis, non-union, in which fusion of the trapezium bone with the metacarpal bone fails, occurs in 8% to 21% of the cases.
131:
of the other four fingers which are ellipsoid joints. This means that the surfaces of the TMC joint are both concave and convex.
763:
North ER, Eaton RG (March 1983). "Degenerative joint disease of the trapezium: a comparative radiographic and anatomic study".
987:
Becker, Stéphanie J. E.; Teunis, Teun; Blauth, Johann; Kortlever, Joost T. P.; Dyer, George S. M.; Ring, David (March 2015).
2131:"Prevalence and pattern of radiographic hand osteoarthritis and association with pain and disability (the Rotterdam study)"
1560:"Current trends in nonoperative and operative treatment of trapeziometacarpal osteoarthritis: a survey of US hand surgeons"
1276:
1260:
887:"Osteoarthritis in the carpometacarpal joint of the thumb. Prevalence and associations with disability and mortality"
318:
The best available evidence suggests no difference in symptom alleviation with these variations of TMC arthroplasty.
1119:"Factors Associated With Radiographic Trapeziometacarpal Arthrosis in Patients Not Seeking Care for This Condition"
67:
osteoarthritis at the base of the thumb, thumb carpometacarpal osteoarthritis, basilar (or basal) joint arthritis,
1373:
Eaton RG, Glickel SZ (November 1987). "Trapeziometacarpal osteoarthritis. Staging as a rationale for treatment".
1827:
Blank J, Feldon P (1997). "Thumb metacarpophalangeal joint stabilization during carpometacarpal joint surgery".
1176:"Osteoarthritis of the thumb carpometacarpal joint in women and occupational risk factors: a case-control study"
472:
989:"Medical services and associated costs vary widely among surgeons treating patients with hand osteoarthritis"
417:
583:
TACCARDO, GIUSEPPE; DE VITIS, ROCCO; PARRONE, GIUSEPPE; MILANO, GIUSEPPE; FANFANI, FRANCESCO (2014-01-08).
304:
modifying surgery for more limited arthrosis, but there is no experimental support for this theory.
362:
The tendon is then formed into a circular shape and placed in the gap, where it is stabilized by sutures.
2189:
2045:
Weilby A, Søndorf J (March 1978). "Results following removal of silicone trapezium metacarpal implants".
1462:"Osteotomy versus tendon arthroplasty in trapeziometacarpal arthrosis: 17 patients followed for 1 year"
478:
Other general complications include superficial radial nerve damage and postoperative wound infection.
330:
each procedure. Trapeziectomy alone is associated with fewer complications than the other procedures.
432:
It’s not clear within the current literature that a prosthesis has any advantage over trapeziectomy.
275:
1757:
Gervis W.H. (1949). "Excision of the trapezium for osteoarthritis of the trapeziometacarpal joint".
1664:
Wajon, Anne; Vinycomb, Toby; Carr, Emma; Edmunds, Ian; Ada, Louise (2015-02-23). Wajon, Anne (ed.).
115:
symptoms unrelated to TMC OA demonstrated no relationship of radiographic TMC OA to hand activity.
1174:
Fontana, Luc; Neel, Stéphanie; Claise, Jean-Marc; Ughetto, Sylvie; Catilina, Pierre (April 2007).
679:
Becker, Stéphanie J. E.; Briet, Jan Paul; Hageman, Michiel G. J. S.; Ring, David (December 2013).
1090:
Carr M. M., Freiberg A. (1994). "Osteoarthritis of the thumb: Clinical aspects and management".
932:
Wilkens, Suzanne C.; Ring, David; Teunis, Teun; Lee, Sang-Gil P.; Chen, Neal C. (March 2019).
128:
268:
in diameter, are present (usually adjacent to the volar and dorsal facets of the trapezium)
256:
in diameter, are present. (usually adjacent to the volar or dorsal facets of the trapezium)
179:
1792:
Weilby A (1988). "Tendon interposition arthroplasty of the first carpo-metacarpal joint".
8:
475:. This is a syndrome of chronic pain with changes of temperature and colour of the skin.
1325:"Contact patterns in the trapeziometacarpal joint: the role of the palmar beak ligament"
190:
TMC OA severity was classified by Eaton and
Littler which can be simplified as follows:
2184:
2155:
2130:
2108:
1986:
1978:
1943:
1918:
1698:
1665:
1540:
1151:
1118:
1072:
1060:
1021:
988:
969:
713:
680:
609:
584:
557:
524:
2058:
1859:
1386:
858:
814:
776:
653:
636:
2160:
2100:
2096:
2062:
2027:
1967:
1948:
1899:
1863:
1809:
1805:
1774:
1739:
1703:
1685:
1646:
1638:
1587:
1579:
1532:
1524:
1483:
1437:
1429:
1390:
1346:
1341:
1324:
1305:
1272:
1256:
1238:
1203:
1195:
1156:
1138:
1099:
1064:
1026:
1008:
961:
953:
914:
906:
902:
862:
818:
780:
745:
718:
700:
658:
614:
596:
562:
544:
49:
2112:
1117:
Wilkens, Suzanne C.; Tarabochia, Matthew A.; Ring, David; Chen, Neal C. (May 2019).
973:
845:
Glickel SZ (May 2001). "Clinical assessment of the thumb trapeziometacarpal joint".
2150:
2142:
2092:
2054:
2017:
1963:
1959:
1938:
1934:
1930:
1891:
1855:
1801:
1766:
1731:
1693:
1681:
1677:
1630:
1571:
1544:
1514:
1473:
1421:
1382:
1336:
1297:
1230:
1187:
1146:
1130:
1076:
1056:
1016:
1000:
945:
898:
854:
810:
772:
708:
692:
648:
604:
552:
536:
74:
36:
2129:
Dahaghin S, Bierma-Zeinstra SM, Ginai AZ, Pols HA, Hazes JM, Koes BW (May 2005).
1408:
Sodha, Samir; Ring, David; Zurakowski, David; Jupiter, Jesse B. (December 2005).
343:
54:
2022:
2005:
421:
X-ray of trapeziometacarpal joint replacement. Left hand of a 58-year-old woman.
1770:
1735:
1634:
1575:
1519:
1502:
1191:
949:
82:
1917:
Wajon A, Vinycomb T, Carr E, Edmunds I, Ada L (February 2015). Wajon A (ed.).
1478:
1461:
1004:
934:"Decision Aid for Trapeziometacarpal Arthritis: A Randomized Controlled Trial"
696:
540:
429:
Prostheses come in many varieties, such as spacers or resurfacing prostheses.
279:
Stage 4 trapeziometacarpal osteoarthritis, with major subluxation of the joint
2178:
1689:
1642:
1583:
1528:
1433:
1199:
1142:
1134:
1012:
957:
910:
704:
600:
548:
321:
134:
This shape provides the TMC joint a wide range of motion. Movements include:
2146:
1895:
1559:
1409:
1175:
933:
886:
2164:
1971:
1952:
1903:
1778:
1743:
1707:
1650:
1591:
1536:
1441:
1309:
1301:
1242:
1234:
1207:
1160:
1068:
1030:
965:
918:
866:
722:
618:
566:
377:
2104:
2031:
1975:. If this is an intentional citation to a retracted paper, please replace
1867:
1813:
1487:
1394:
1350:
1103:
822:
784:
749:
662:
2066:
1425:
484:
442:
399:
311:
523:
Patel, Tejas J.; Beredjiklian, Pedro K.; Matzon, Jonas L. (2012-12-16).
342:
An empty gap is left by the trapeziectomy and the wound is closed with
87:
81:
bone of the thumb. This is one of the joints where most humans develop
78:
164:
106:
when the TMC joint is moved, more so when axial pressure is applied.
488:
2006:"First metacarpal osteotomy for trapeziometacarpal osteoarthritis"
1220:
2128:
1501:
Bachoura, Abdo; Yakish, Eric J.; Lubahn, John D. (August 2018).
585:"Surgical treatment of trapeziometacarpal joint osteoarthritis"
90:(also known as “bone spurs”), are formed at the joint margins.
1410:"Prevalence of osteoarthrosis of the trapeziometacarpal joint"
1287:
1919:"Surgery for thumb (trapeziometacarpal joint) osteoarthritis"
1720:
1666:"Surgery for thumb (trapeziometacarpal joint) osteoarthritis"
884:
582:
365:
315:
was, either a tendon wrapped up into a ball or a prosthesis.
1880:
1619:
1558:
Wolf, Jennifer
Moriatis; Delaronde, Steven (January 2012).
986:
801:
Burton R. I. (1973). "Basal joint arthrosis of the thumb".
1407:
1322:
349:
222:< 1/3 subluxation of the joint (in any projection)
1116:
2082:
1916:
1663:
1173:
1615:
1613:
1611:
1609:
1607:
1605:
1603:
1601:
1271:
Gray's
Anatomy for Students, second edition, Elsevier,
1089:
522:
1459:
1414:
The
Journal of Bone and Joint Surgery. American Volume
891:
The
Journal of Bone and Joint Surgery. American Volume
678:
1323:
Pellegrini VD, Olcott CW, Hollenberg G (March 1993).
1598:
1500:
931:
182:) although these are usually easy to distinguish.
2003:
1826:
2176:
1845:
681:"Death, taxes, and trapeziometacarpal arthrosis"
2124:
2122:
1460:Atroshi I, Axelsson G, Nilsson EL (June 1998).
1042:
1040:
1455:
1453:
1451:
840:
838:
836:
834:
832:
391:procedures have comparable long-term results.
44:Osteoarthritis of the trapeziometacarpal joint
2044:
1557:
630:
628:
371:are not supported by experimental evidence.
2119:
1910:
1874:
1714:
1372:
1214:
1046:
1037:
800:
109:
2004:Hobby JL, Lyall HA, Meggitt BF (May 1998).
1997:
1839:
1756:
1670:The Cochrane Database of Systematic Reviews
1448:
1366:
1316:
829:
529:Current Reviews in Musculoskeletal Medicine
2038:
1989:|...|intentional=yes}}
993:Clinical Orthopaedics and Related Research
762:
756:
729:
685:Clinical Orthopaedics and Related Research
634:
625:
385:
366:Trapeziectomy with ligament reconstruction
63:Trapeziometacarpal osteoarthritis (TMC OA)
35:
2154:
2021:
1942:
1697:
1518:
1477:
1340:
1150:
1020:
712:
652:
608:
578:
576:
556:
518:
516:
1791:
441:
416:
376:
320:
274:
163:
844:
450:
350:Trapeziectomy with tendon interposition
2177:
735:
573:
513:
325:Showing the forces after trapeziectomy
2078:
2076:
1255:Sobotta Anatomy, 14th ed., Elsevier,
290:Concomitant scaphotrapezial arthritis
97:
880:
878:
876:
796:
794:
674:
672:
525:"Trapeziometacarpal joint arthritis"
412:
1750:
13:
2073:
1357:
1083:
1061:10.1097/01.prs.0000214652.31293.23
219:slight widening of the joint space
14:
2201:
873:
791:
669:
185:
22:Trapeziometacarpal osteoarthritis
903:10.2106/00004623-200407000-00013
465:
333:
1820:
1785:
1657:
1551:
1494:
1401:
1281:
1265:
1249:
1167:
1110:
980:
925:
738:Nippon Seikeigeka Gakkai Zasshi
635:Pelligrini VD (November 1991).
497:
1964:10.1002/14651858.CD004631.pub5
1935:10.1002/14651858.CD004631.pub4
1682:10.1002/14651858.CD004631.pub4
473:complex regional pain syndrome
394:
73:. This joint is formed by the
1:
2059:10.1016/s0363-5023(78)80064-1
1860:10.1016/s0363-5023(86)80137-x
1387:10.1016/S0749-0712(21)00761-7
859:10.1016/S0749-0712(21)00239-0
815:10.1016/S0030-5898(20)30797-5
777:10.1016/s0363-5023(83)80008-2
654:10.1016/S0363-5023(10)80055-3
506:
168:Showing the bones of the hand
2097:10.1016/0266-7681(94)90085-X
1806:10.1016/0266-7681(88)90171-4
1342:10.1016/0363-5023(93)90354-6
298:
271:Slight joint space narrowing
172:
7:
2023:10.1302/0301-620x.80b3.8199
1623:The Journal of Hand Surgery
1564:The Journal of Hand Surgery
1507:The Journal of Hand Surgery
1180:The Journal of Hand Surgery
938:The Journal of Hand Surgery
736:Kihara H (April 1992). "".
10:
2206:
1923:Cochrane Database Syst Rev
1771:10.1302/0301-620X.31B4.537
1736:10.1016/j.jhsa.2011.11.027
1635:10.1016/j.jhsa.2010.10.028
1576:10.1016/j.jhsa.2011.10.010
1520:10.1016/j.jhsa.2018.01.005
1192:10.1016/j.jhsa.2007.01.014
950:10.1016/j.jhsa.2018.06.004
122:
77:bone of the wrist and the
1479:10.3109/17453679809000932
1005:10.1007/s11999-014-3912-3
697:10.1007/s11999-013-3243-9
541:10.1007/s12178-012-9147-6
110:Etiology and Epidemiology
48:
43:
34:
26:
21:
1135:10.1177/1558944717732064
381:Arthrodesis of the thumb
2147:10.1136/ard.2004.023564
1896:10.1053/jhsu.2001.26659
386:Trapeziectomy with LRTI
1302:10.1053/jhsu.1999.0786
1235:10.1053/jhsu.1999.0496
803:Orthop. Clin. North Am
447:
446:Osteotomy of the thumb
422:
382:
326:
280:
169:
1981:|...}}
1958:(Retracted, see
1123:Hand (New York, N.Y.)
1049:Plast. Reconstr. Surg
445:
420:
380:
324:
278:
167:
2010:J Bone Joint Surg Br
1513:(8): 772.e1–772.e7.
1426:10.2106/JBJS.E.00104
944:(3): 247.e1–247.e9.
451:Metacarpal osteotomy
180:De Quervain syndrome
2190:Skeletal disorders
1092:Am. Fam. Physician
448:
423:
383:
327:
287:Narrow joint space
281:
170:
98:Signs and symptoms
65:is, also known as
1759:J Bone Joint Surg
1466:Acta Orthop Scand
1420:(12): 2614–2618.
1098:(995): 995–1000.
691:(12): 3738–3744.
413:Joint replacement
60:
59:
16:Medical condition
2197:
2169:
2168:
2158:
2126:
2117:
2116:
2080:
2071:
2070:
2042:
2036:
2035:
2025:
2001:
1995:
1994:
1992:
1990:
1982:
1956:
1946:
1914:
1908:
1907:
1878:
1872:
1871:
1843:
1837:
1836:
1824:
1818:
1817:
1789:
1783:
1782:
1754:
1748:
1747:
1718:
1712:
1711:
1701:
1661:
1655:
1654:
1617:
1596:
1595:
1555:
1549:
1548:
1522:
1498:
1492:
1491:
1481:
1457:
1446:
1445:
1405:
1399:
1398:
1370:
1364:
1361:
1355:
1354:
1344:
1320:
1314:
1313:
1285:
1279:
1269:
1263:
1253:
1247:
1246:
1218:
1212:
1211:
1171:
1165:
1164:
1154:
1114:
1108:
1107:
1087:
1081:
1080:
1055:(6): 116e–128e.
1044:
1035:
1034:
1024:
999:(3): 1111–1117.
984:
978:
977:
929:
923:
922:
897:(7): 1452–1457.
882:
871:
870:
842:
827:
826:
798:
789:
788:
760:
754:
753:
733:
727:
726:
716:
676:
667:
666:
656:
632:
623:
622:
612:
580:
571:
570:
560:
520:
267:
255:
39:
19:
18:
2205:
2204:
2200:
2199:
2198:
2196:
2195:
2194:
2175:
2174:
2173:
2172:
2135:Ann. Rheum. Dis
2127:
2120:
2081:
2074:
2043:
2039:
2002:
1998:
1984:
1976:
1974:
1957:
1929:(2): CD004631.
1915:
1911:
1879:
1875:
1844:
1840:
1829:Atlas Hand Clin
1825:
1821:
1790:
1786:
1755:
1751:
1719:
1715:
1676:(2): CD004631.
1662:
1658:
1618:
1599:
1556:
1552:
1499:
1495:
1458:
1449:
1406:
1402:
1371:
1367:
1362:
1358:
1321:
1317:
1286:
1282:
1270:
1266:
1254:
1250:
1219:
1215:
1172:
1168:
1115:
1111:
1088:
1084:
1045:
1038:
985:
981:
930:
926:
883:
874:
843:
830:
799:
792:
761:
757:
740:(in Japanese).
734:
730:
677:
670:
633:
626:
581:
574:
521:
514:
509:
500:
468:
453:
415:
397:
388:
368:
352:
336:
301:
265:
253:
188:
175:
125:
112:
100:
55:Plastic surgery
17:
12:
11:
5:
2203:
2193:
2192:
2187:
2171:
2170:
2118:
2091:(3): 340–341.
2072:
2047:J Hand Surg Am
2037:
1996:
1909:
1884:J Hand Surg Am
1873:
1848:J Hand Surg Am
1838:
1819:
1800:(4): 421–425.
1794:J Hand Surg Br
1784:
1765:(4): 537–539.
1749:
1724:J Hand Surg Am
1713:
1656:
1629:(1): 157–169.
1597:
1550:
1493:
1447:
1400:
1365:
1356:
1329:J Hand Surg Am
1315:
1296:(4): 786–798.
1290:J Hand Surg Am
1280:
1264:
1248:
1229:(3): 496–504.
1223:J Hand Surg Am
1213:
1186:(4): 459–465.
1166:
1129:(3): 364–370.
1109:
1082:
1036:
979:
924:
872:
828:
809:(347): 331–8.
790:
765:J Hand Surg Am
755:
728:
668:
641:J Hand Surg Am
624:
595:(3): 138–144.
572:
511:
510:
508:
505:
499:
496:
467:
464:
452:
449:
414:
411:
396:
393:
387:
384:
367:
364:
351:
348:
335:
332:
300:
297:
292:
291:
288:
273:
272:
269:
258:
257:
246:
245:
244:
243:
242:
241:
240:
239:
238:
237:
236:
235:
234:
233:
232:
231:
230:
229:
228:
227:
226:
225:
224:
223:
220:
187:
186:Classification
184:
174:
171:
158:
157:
154:
151:
148:
145:
142:
139:
124:
121:
111:
108:
99:
96:
83:osteoarthritis
58:
57:
52:
46:
45:
41:
40:
32:
31:
28:
24:
23:
15:
9:
6:
4:
3:
2:
2202:
2191:
2188:
2186:
2183:
2182:
2180:
2166:
2162:
2157:
2152:
2148:
2144:
2140:
2136:
2132:
2125:
2123:
2114:
2110:
2106:
2102:
2098:
2094:
2090:
2086:
2079:
2077:
2068:
2064:
2060:
2056:
2052:
2048:
2041:
2033:
2029:
2024:
2019:
2016:(3): 508–12.
2015:
2011:
2007:
2000:
1988:
1980:
1973:
1969:
1965:
1961:
1954:
1950:
1945:
1940:
1936:
1932:
1928:
1924:
1920:
1913:
1905:
1901:
1897:
1893:
1890:(5): 869–76.
1889:
1885:
1877:
1869:
1865:
1861:
1857:
1854:(3): 324–32.
1853:
1849:
1842:
1834:
1830:
1823:
1815:
1811:
1807:
1803:
1799:
1795:
1788:
1780:
1776:
1772:
1768:
1764:
1760:
1753:
1745:
1741:
1737:
1733:
1729:
1725:
1717:
1709:
1705:
1700:
1695:
1691:
1687:
1683:
1679:
1675:
1671:
1667:
1660:
1652:
1648:
1644:
1640:
1636:
1632:
1628:
1624:
1616:
1614:
1612:
1610:
1608:
1606:
1604:
1602:
1593:
1589:
1585:
1581:
1577:
1573:
1569:
1565:
1561:
1554:
1546:
1542:
1538:
1534:
1530:
1526:
1521:
1516:
1512:
1508:
1504:
1497:
1489:
1485:
1480:
1475:
1472:(3): 287–90.
1471:
1467:
1463:
1456:
1454:
1452:
1443:
1439:
1435:
1431:
1427:
1423:
1419:
1415:
1411:
1404:
1396:
1392:
1388:
1384:
1381:(4): 455–71.
1380:
1376:
1369:
1360:
1352:
1348:
1343:
1338:
1335:(2): 238–44.
1334:
1330:
1326:
1319:
1311:
1307:
1303:
1299:
1295:
1291:
1284:
1278:
1277:9780443069529
1274:
1268:
1262:
1261:9780702034831
1258:
1252:
1244:
1240:
1236:
1232:
1228:
1224:
1217:
1209:
1205:
1201:
1197:
1193:
1189:
1185:
1181:
1177:
1170:
1162:
1158:
1153:
1148:
1144:
1140:
1136:
1132:
1128:
1124:
1120:
1113:
1105:
1101:
1097:
1093:
1086:
1078:
1074:
1070:
1066:
1062:
1058:
1054:
1050:
1043:
1041:
1032:
1028:
1023:
1018:
1014:
1010:
1006:
1002:
998:
994:
990:
983:
975:
971:
967:
963:
959:
955:
951:
947:
943:
939:
935:
928:
920:
916:
912:
908:
904:
900:
896:
892:
888:
881:
879:
877:
868:
864:
860:
856:
853:(2): 185–95.
852:
848:
841:
839:
837:
835:
833:
824:
820:
816:
812:
808:
804:
797:
795:
786:
782:
778:
774:
770:
766:
759:
751:
747:
744:(4): 228–39.
743:
739:
732:
724:
720:
715:
710:
706:
702:
698:
694:
690:
686:
682:
675:
673:
664:
660:
655:
650:
647:(6): 975–82.
646:
642:
638:
631:
629:
620:
616:
611:
606:
602:
598:
594:
590:
586:
579:
577:
568:
564:
559:
554:
550:
546:
542:
538:
534:
530:
526:
519:
517:
512:
504:
495:
492:
490:
486:
482:
479:
476:
474:
466:Complications
463:
460:
457:
444:
440:
437:
433:
430:
427:
419:
410:
407:
404:
401:
392:
379:
375:
372:
363:
360:
356:
347:
345:
340:
339:into pieces.
334:Trapeziectomy
331:
323:
319:
316:
313:
309:
305:
296:
289:
286:
285:
284:
277:
270:
264:Osteophytes,
263:
262:
261:
252:Osteophytes,
251:
250:
249:
221:
218:
217:
216:
215:
214:
213:
212:
211:
210:
209:
208:
207:
206:
205:
204:
203:
202:
201:
200:
199:
198:
197:
196:
195:
194:
191:
183:
181:
166:
162:
156:Circumduction
155:
152:
149:
146:
143:
140:
137:
136:
135:
132:
130:
120:
116:
107:
103:
95:
91:
89:
84:
80:
76:
72:
71:rhizarthrosis
68:
64:
56:
53:
51:
47:
42:
38:
33:
29:
25:
20:
2141:(5): 682–7.
2138:
2134:
2088:
2084:
2053:(2): 154–6.
2050:
2046:
2040:
2013:
2009:
1999:
1985:{{
1977:{{
1926:
1922:
1912:
1887:
1883:
1876:
1851:
1847:
1841:
1832:
1828:
1822:
1797:
1793:
1787:
1762:
1758:
1752:
1730:(3): 411–7.
1727:
1723:
1716:
1673:
1669:
1659:
1626:
1622:
1570:(1): 77–82.
1567:
1563:
1553:
1510:
1506:
1496:
1469:
1465:
1417:
1413:
1403:
1378:
1374:
1368:
1359:
1332:
1328:
1318:
1293:
1289:
1283:
1267:
1251:
1226:
1222:
1216:
1183:
1179:
1169:
1126:
1122:
1112:
1095:
1091:
1085:
1052:
1048:
996:
992:
982:
941:
937:
927:
894:
890:
850:
846:
806:
802:
771:(2): 160–6.
768:
764:
758:
741:
737:
731:
688:
684:
644:
640:
592:
588:
532:
528:
501:
498:Epidemiology
493:
483:
480:
477:
469:
461:
458:
454:
438:
434:
431:
428:
424:
408:
405:
398:
389:
373:
369:
361:
357:
353:
341:
337:
328:
317:
310:
306:
302:
293:
282:
259:
247:
192:
189:
176:
159:
133:
126:
117:
113:
104:
101:
92:
70:
66:
62:
61:
2085:J Hand Surg
485:Subluxation
456:arthritis.
400:Arthrodesis
395:Arthrodesis
312:Arthrodesis
94:arthritis.
88:osteophytes
27:Other names
2179:Categories
1835:: 217–225.
535:(1): 1–8.
507:References
153:Reposition
150:Opposition
129:CMC joints
79:metacarpal
2185:Arthritis
1987:retracted
1979:retracted
1690:1469-493X
1643:0363-5023
1584:1531-6564
1529:1531-6564
1434:0021-9355
1375:Hand Clin
1200:0363-5023
1143:1558-9447
1013:1528-1132
958:1531-6564
911:0021-9355
847:Hand Clin
705:1528-1132
601:2512-9090
549:1935-973X
299:Treatment
283:Stage 4:
266:> 2 mm
260:Stage 3:
254:< 2 mm
248:Stage 2:
193:Stage 1:
173:Diagnosis
147:Adduction
144:Abduction
141:Extension
75:trapezium
50:Specialty
2165:15374852
2113:26424006
1972:28368089
1953:25702783
1904:11561240
1779:15397137
1744:22305824
1708:25702783
1651:21193136
1592:22119601
1537:29503049
1442:16322609
1310:10447171
1243:10357527
1208:17398355
1161:28918660
1069:16651933
1031:25171936
974:51709751
966:30031600
919:15252092
867:11478041
723:23959907
619:25606524
567:23242976
489:luxation
2156:1755481
2105:8077824
2032:9619947
1944:6464627
1868:3711604
1814:3249143
1699:6464627
1545:3709534
1488:9703405
1395:3693416
1351:8463587
1152:6535938
1104:7942418
1077:6741548
1022:4317453
823:4707436
785:6833724
750:1593195
714:3825869
663:1748768
610:4295705
558:3702767
436:costs.
344:sutures
138:Flexion
123:Anatomy
2163:
2153:
2111:
2103:
2067:632545
2065:
2030:
1970:
1966:,
1951:
1941:
1902:
1866:
1812:
1777:
1742:
1706:
1696:
1688:
1649:
1641:
1590:
1582:
1543:
1535:
1527:
1486:
1440:
1432:
1393:
1349:
1308:
1275:
1259:
1241:
1206:
1198:
1159:
1149:
1141:
1102:
1075:
1067:
1029:
1019:
1011:
972:
964:
956:
917:
909:
865:
821:
783:
748:
721:
711:
703:
661:
617:
607:
599:
589:Joints
565:
555:
547:
69:or as
2109:S2CID
1983:with
1541:S2CID
1073:S2CID
970:S2CID
2161:PMID
2101:PMID
2063:PMID
2028:PMID
1968:PMID
1949:PMID
1927:2015
1900:PMID
1864:PMID
1810:PMID
1775:PMID
1740:PMID
1704:PMID
1686:ISSN
1674:2015
1647:PMID
1639:ISSN
1588:PMID
1580:ISSN
1533:PMID
1525:ISSN
1484:PMID
1438:PMID
1430:ISSN
1391:PMID
1347:PMID
1306:PMID
1273:ISBN
1257:ISBN
1239:PMID
1204:PMID
1196:ISSN
1157:PMID
1139:ISSN
1100:PMID
1065:PMID
1027:PMID
1009:ISSN
962:PMID
954:ISSN
915:PMID
907:ISSN
863:PMID
819:PMID
781:PMID
746:PMID
719:PMID
701:ISSN
659:PMID
615:PMID
597:ISSN
563:PMID
545:ISSN
2151:PMC
2143:doi
2093:doi
2089:19B
2055:doi
2018:doi
1960:doi
1939:PMC
1931:doi
1892:doi
1856:doi
1802:doi
1767:doi
1763:31B
1732:doi
1694:PMC
1678:doi
1631:doi
1572:doi
1515:doi
1474:doi
1422:doi
1383:doi
1337:doi
1298:doi
1231:doi
1188:doi
1147:PMC
1131:doi
1057:doi
1053:117
1017:PMC
1001:doi
997:473
946:doi
899:doi
855:doi
811:doi
773:doi
709:PMC
693:doi
689:471
649:doi
605:PMC
553:PMC
537:doi
2181::
2159:.
2149:.
2139:64
2137:.
2133:.
2121:^
2107:.
2099:.
2087:.
2075:^
2061:.
2049:.
2026:.
2014:80
2012:.
2008:.
1947:.
1937:.
1925:.
1921:.
1898:.
1888:26
1886:.
1862:.
1852:11
1850:.
1831:.
1808:.
1798:13
1796:.
1773:.
1761:.
1738:.
1728:37
1726:.
1702:.
1692:.
1684:.
1672:.
1668:.
1645:.
1637:.
1627:36
1625:.
1600:^
1586:.
1578:.
1568:37
1566:.
1562:.
1539:.
1531:.
1523:.
1511:43
1509:.
1505:.
1482:.
1470:69
1468:.
1464:.
1450:^
1436:.
1428:.
1418:87
1416:.
1412:.
1389:.
1377:.
1345:.
1333:18
1331:.
1327:.
1304:.
1294:24
1292:.
1237:.
1227:24
1225:.
1202:.
1194:.
1184:32
1182:.
1178:.
1155:.
1145:.
1137:.
1127:14
1125:.
1121:.
1096:50
1094:.
1071:.
1063:.
1051:.
1039:^
1025:.
1015:.
1007:.
995:.
991:.
968:.
960:.
952:.
942:44
940:.
936:.
913:.
905:.
895:86
893:.
889:.
875:^
861:.
851:17
849:.
831:^
817:.
805:.
793:^
779:.
767:.
742:66
717:.
707:.
699:.
687:.
683:.
671:^
657:.
645:16
643:.
639:.
627:^
613:.
603:.
591:.
587:.
575:^
561:.
551:.
543:.
531:.
527:.
515:^
2167:.
2145::
2115:.
2095::
2069:.
2057::
2051:3
2034:.
2020::
1993:)
1991:.
1962::
1955:.
1933::
1906:.
1894::
1870:.
1858::
1833:2
1816:.
1804::
1781:.
1769::
1746:.
1734::
1710:.
1680::
1653:.
1633::
1594:.
1574::
1547:.
1517::
1490:.
1476::
1444:.
1424::
1397:.
1385::
1379:3
1353:.
1339::
1312:.
1300::
1245:.
1233::
1210:.
1190::
1163:.
1133::
1106:.
1079:.
1059::
1033:.
1003::
976:.
948::
921:.
901::
869:.
857::
825:.
813::
807:4
787:.
775::
769:8
752:.
725:.
695::
665:.
651::
621:.
593:1
569:.
539::
533:6
178:(
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