Background
Epidemiology
Much less common than hip and knee OA
Patients tend to be younger
Much less common than hip and knee OA
Patients tend to be younger
Usually after 50-60 years of age
Primary 90% of cases
Secondary
- AVN
- trauma
- instability
Epidemiology
- seen in women over 40
Xray
- sclerotic and overgrown
CT
OA of the scapho-trapezium-trapezoidal joints
50% patients with CMC OA have STT OA
F > M
Return to Sport
Shelbourne et al. Am J Sports Med 1999
- 133 patients with isolated PCL injuries followed for mean of 5 years
- 1/2 returned to sport at same level of play
- 1/3 returned to sport at lower level of play
https://pubmed.ncbi.nlm.nih.gov/10352760/
Agolley et al. Bone Joint J 2017
Resuscitation
EMST
Neurovascular assessment
Investigations - exclude Pipkin, NOF
Emergent reduction / skeletal stabilisation
Assess stability
Re-evaluate sciatic nerve
Indications
- displaced acetabular fracture
I. Lateral Spilt
- seen in young patient
- lateral meniscus can be incarcerated in fracture
II. Lateral Split Depression
- often seen in young patients with high energy injuries
- vary in severity
Fewer complications than TSR
Simpler procedure
OA
Psoriasis
CREST (scleroderma)
RA (rare form)
Other seronegative arthropathies
Hyperparathyroidism
Reactive arthropathy
Gout
Diagnosis
Pisotriquetral view
- forearm positioned 30° supinated off the neutral position
- loss of symmetry between the pisiform and triquetrum is required for the diagnosis
- carpal tunnel view may be helpful in further assessment of the joint
Clinical
More common problem