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2014, Número 1

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Cir Plast 2014; 24 (1)


Tratamiento de la rizartrosis con artroplastia tipo Eaton

Sastré GH, Torres GB, Ugalde VA, Sastré N

Idioma: Español
Referencias bibliográficas: 38
Paginas: 31-39
Archivo PDF: 644.23 Kb.


RESUMEN

La osteoartrosis trapecio-metacarpiana afecta al 10% de mujeres en edad media y es más frecuente en mujeres postmenopáusicas. Es un trastorno degenerativo del cartílago articular y es la segunda articulación en frecuencia que se ve afectada. Se debe a la debilidad del ligamento palmar profundo que permite el desplazamiento anómalo dorsal del primer metacarpiano en diversos movimientos. El dolor es el primer síntoma; aparece con la abducción completa del pulgar y al hacer la pinza lateral. Conforme aumenta la enfermedad puede presentarse limitación en la abducción del pulgar y una deformidad en el borde radial de la articulación, por la subluxación del primer metacarpiano. Eaton distinguió cuatro grados de la enfermedad y de acuerdo con ellos se hace el tratamiento quirúrgico. Se presenta la experiencia con 58 manos con diferentes grados. A las de grado 1 se les hizo reconstrucción del ligamento y a las de grados 2, 3 y 4 se les hizo trapecectomía parcial, reconstrucción ligamentaria e interposición tendinosa. Se obtuvo después de tres meses y un año desaparición del dolor y sintomatología en 54 casos (93.86%). Sólo un caso tuvo que ser reoperado.


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