Dr POUMELLEC Marie-Anne

Total Thumb Carpometacarpal Joint Arthroplasty: A Retrospective Functional Study of 28 MOOVIS Prostheses

Nicolas Dreant, Marie-Anne Poumellec

https://pubmed.ncbi.nlm.nih.gov/30246549/

Abstract

Background: Trapeziometacarpal prostheses have been used for more than 50 years in the treatment of first carpometacarpal joint arthritis. Even though this technique is more expensive than trapeziectomy, it has many advantages such as faster convalescence with better patient comfort and improved strength and range of motion. The aim of this study was to report the early functional results of a patient cohort treated with a dual mobility thumb carpometacarpal joint prosthesis.

Methods: A retrospective study was performed to assess the functional results of 25 patients treated for trapeziometacarpal advanced osteoarthritis (Eaton and Littler stage III) with 28 MOOVIS prostheses. Preoperative and postoperative assessments included pain, range of motion, and pinch and grip strength. The average follow-up time was 27.5 months.

Results: The mean pain score measured by a visual analog scale was 8 preoperatively and 1 postoperatively. The mean preoperative Kapandji opposition score was 7 and counter-opposition score was 1; postoperative scores were 10 and 4, respectively. The grip strength improved after the surgery and the results were compared separately between dominant and nondominant sides. Final functional results were good: the mean Quick Disabilities of the Arm, Shoulder and Hand Questionnaire score was 12, and the mean Michigan Hand Outcomes score was 87%.

Conclusions: Total joint arthroplasty with a dual mobility prosthesis appears to be a satisfactory solution in our series. The absence of prosthesis instability encourages us to recommend this technique for the treatment of advanced trapeziometacarpal osteoarthritis for people having an activity without too many manual constraints.

Keywords: carpometacarpal; dual mobility; osteoarthritis; thumb; trapeziometacarpal prosthesis.

Douleur de hanche fébrile chez un adolescent judoka

T. Langlais, C. Morina, M.A. Poumellec, C. Ursua, J.C. Leonarda, Sci Sport. 2017

Elastic retrograde intramedullary percutaneous pinning for fifth metacarpal neck fractures: A series of 32 patients

M-A Poumellec, N Dreant

https://pubmed.ncbi.nlm.nih.gov/28551317/

Abstract

The aim of our study was to evaluate an original surgical technique for the treatment of fifth metacarpal neck fractures: elastic retrograde intramedullary percutaneous pinning (ERIPP). From January 2014 to January 2016, patients with a fifth metacarpal neck fracture with greater than 30° volar displacement and/or clinodactyly were included. All patients underwent an ERIPP procedure. With this technique, K-wires are used as joysticks to assist reduction when the Jahss maneuver is insufficient. Clinical evaluation incorporated the DASH score, range of motion and grip strength at 3months. Radiographic evaluation comprised apex dorsal angulation and metacarpal shortening at 1month and 3months. Thirty-two patients were included in the study. All fractures were healed after a mean of 5 weeks (range 4-7). The DASH score was less than 30 for all patients, indicating an absence of disability. There were no differences in grip strength at 3months between the injured and the contralateral hand. There was less than 10° extension deficit in the metacarpophalangeal joint. In our experience, retrograde percutaneous pinning is a stable, compressive fixation method with effective reduction of displaced fifth metacarpal neck fractures. However, this result needs to be confirmed in comparative studies.
Keywords: Brochage rétrograde centromédullaire; Col du cinquième métacarpien; Fifth metacarpal neck; Fracture; K-wire; Retrograde intramedullary pinning.

Copyright © 2017 SFCM. Published by Elsevier Masson SAS. All rights reserved.