September 2014, ONS orthopedic hand surgeon Dr. Mark Vitale traveled to Boston for the 69th annual American Society for Surgery of the Hand (ASSH), the premier annual hand surgery meeting where the nation’s leading hand surgeons gather to present new research and techniques for the care of hand, wrist, nerve and upper extremity problems.
Dr. Vitale presented two of the conferences’ 84 podium presentations to the community of hand surgeons in the U.S. and abroad. One of his presentations entitled, “Intra-articular fractures of the sigmoid notch of the distal radius: an analysis of progression to distal radioulnar joint arthritis and impact on upper extremity function in surgically treated fractures,” was a study that looked at fractures of one of the understudied joints of the wrist. This study will help surgeons guide treatment of these fractures to optimize wrist function in surgically treated fractures.
Traditional treatments for thumb arthritis involve removing the arthritic bone in the wrist called the trapezium which forms a joint with the base of the thumb and then using part of a patient’s own tendon to reconstruct the thumb. Dr. Vitale’s research revealed that the results with this more traditional “trapeziectomy” surgery are excellent and time tested.
His second presentation, “A comparison of pyrolytic carbon hemiarthrioplasty versus Thompson suspensionplasty in the treatment of trapezial metacarpal arthritis,” was a study that compared a traditional treatment for thumb arthritis with a new pyrocarbon joint replacement for the thumb.
Pyrolytic carbon joint replacement is a synthetic implant to replace the arthritic thumb/wrist joint that was initially developed and first used in conjunction with hand surgeons at the Mayo Clinic in Rochester, MN. It resurfaces the base of the arthritic thumb metacarpal bone while leaving more of the native trapezium bone in place. The pyrolytic joint replacement implant has been used since the early 2000s. The result of this study found some improved function in patients treated with the pyrocarbon joint replacement, but also a higher risk of need for future surgeries in those treated with the newer joint replacement.
Hand surgeons today debate about what surgical procedures are most appropriate for severely arthritic thumbs. The results of Dr. Vitale’s research will now help guide surgeons around the country to better treat patients.
Dr. Vitale commented, “The ASSH conference was a great success. The ONS Foundation for Clinical Research and Education has provided us with an incredible state of the art research and biomechanics lab from which we continue to drive the field of hand surgery, sports medicine and orthopaedic surgery.”
Orthopaedic and Neurosurgery Specialists PC (ONS) is an advanced multi-specialty orthopedic and neurosurgery practice in Greenwich, CT. ONS physicians provide expertise in sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, please visit www.onsmd.com.