Original article
Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage
Tratamiento de la artrosis escafotrapeciotrapezoidea aislada con artroplastia de recubrimiento con anclaje escafoideo
G. Humada Álvareza,
, C. Simón Pérezb, B. García Medranob, O. Faour Martínc, J.J. Marcos Rodríguezb, A. Vega Castrillob, M.A. Martín Ferrerob
Corresponding author
a Servicio de Cirugía Ortopédica y Traumatología, Hospital Virgen de la Concha, Zamora, Spain
b Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
c Servicio de Cirugía Ortopédica y Traumatología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
Read
4056
Timeswas read the article
1314
Total PDF
2742
Total HTML
Share statistics
array:23 [ "pii" => "S1988885617300810" "issn" => "19888856" "doi" => "10.1016/j.recote.2017.10.010" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "682" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:412-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S1888441517300978" "issn" => "18884415" "doi" => "10.1016/j.recot.2017.05.004" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "682" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:412-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 127 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 108 "PDF" => 16 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Tratamiento de la artrosis escafotrapeciotrapezoidea aislada con artroplastia de recubrimiento con anclaje escafoideo" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "412" "paginaFinal" => "418" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figura 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 559 "Ancho" => 950 "Tamanyo" => 180043 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Pieza resecada del extremo distal del escafoides.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Humada Álvarez, C. Simón Pérez, B. García Medrano, O. Faour Martín, J.J. Marcos Rodríguez, A. Vega Castrillo, M.A. Martín Ferrero" "autores" => array:7 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Humada Álvarez" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Simón Pérez" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "García Medrano" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Faour Martín" ] 4 => array:2 [ "nombre" => "J.J." "apellidos" => "Marcos Rodríguez" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Vega Castrillo" ] 6 => array:2 [ "nombre" => "M.A." "apellidos" => "Martín Ferrero" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1988885617300810" "doi" => "10.1016/j.recote.2017.10.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300810?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300978?idApp=UINPBA00004N" "url" => "/18884415/0000006100000006/v1_201711081107/S1888441517300978/v1_201711081107/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1988885617300809" "issn" => "19888856" "doi" => "10.1016/j.recote.2017.10.009" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "681" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:419-26" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Adult spinal deformity treated with minimally invasive surgery. Description of surgical technique, radiological results and literature review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "419" "paginaFinal" => "426" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Deformidad del adulto tratada mediante cirugía mínimamente invasiva. Técnica quirúrgica, resultados radiológicos y revisión de la literatura" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 552 "Ancho" => 995 "Tamanyo" => 76518 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ravine separator.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Domínguez, R. Luque, M. Noriega, J. Rey, J. Alía, A. Urda, F. Marco" "autores" => array:7 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Domínguez" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Luque" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Noriega" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Rey" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "Alía" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Urda" ] 6 => array:2 [ "nombre" => "F." "apellidos" => "Marco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441517300966" "doi" => "10.1016/j.recot.2017.06.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517300966?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300809?idApp=UINPBA00004N" "url" => "/19888856/0000006100000006/v1_201711201646/S1988885617300809/v1_201711201646/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1988885617300731" "issn" => "19888856" "doi" => "10.1016/j.recote.2017.10.002" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "685" "copyright" => "SECOT" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Cir Ortop Traumatol. 2017;61:404-11" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Surgical treatment of extra-articular distal-third diaphyseal fractures of the humerus using a modified posterior approach and an extra-articular plate" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "404" "paginaFinal" => "411" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de las fracturas diafisarias extraarticulares de húmero distal por abordaje posterior modificado y placa extraarticular" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1272 "Ancho" => 950 "Tamanyo" => 223730 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Healing of modified posterior approach.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. Páramo-Díaz, M. Arroyo-Hernández, V. Rodríguez Vega, M. Aroca-Peinado, J.L. León-Baltasar, P. Caba-Doussoux" "autores" => array:6 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "Páramo-Díaz" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Arroyo-Hernández" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Rodríguez Vega" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Aroca-Peinado" ] 4 => array:2 [ "nombre" => "J.L." "apellidos" => "León-Baltasar" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Caba-Doussoux" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1888441517301108" "doi" => "10.1016/j.recot.2017.07.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1888441517301108?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300731?idApp=UINPBA00004N" "url" => "/19888856/0000006100000006/v1_201711201646/S1988885617300731/v1_201711201646/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "412" "paginaFinal" => "418" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "G. Humada Álvarez, C. Simón Pérez, B. García Medrano, O. Faour Martín, J.J. Marcos Rodríguez, A. Vega Castrillo, M.A. Martín Ferrero" "autores" => array:7 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Humada Álvarez" "email" => array:1 [ 0 => "gonzalohumada@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Simón Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "B." "apellidos" => "García Medrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "O." "apellidos" => "Faour Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "J.J." "apellidos" => "Marcos Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "A." "apellidos" => "Vega Castrillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 6 => array:3 [ "nombre" => "M.A." "apellidos" => "Martín Ferrero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital Virgen de la Concha, Zamora, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Cirugía Ortopédica y Traumatología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la artrosis escafotrapeciotrapezoidea aislada con artroplastia de recubrimiento con anclaje escafoideo" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 900 "Ancho" => 900 "Tamanyo" => 85753 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Intraoperative radiographic image confirming the appropriate placement of the implant.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Scaphotrapeziotrapezoid osteoarthritis (STT) is the second most common cause of arthritis in the wrist,<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">1</span></a> after radioscapholunate arthritis. It can be observed in wrist X-rays in 15–29% of cases,<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> but up to 83% are described in cadaver studies, associated with trapeziometacarpal arthritis.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">3,4</span></a> The reported prevalence of STT in cadavers, in the absence trapeziometacarpal arthritis, varies from 2% to 16% of cases.<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4–6</span></a> Females are most affected and it is associated with advanced age.4,7</p><p id="par0010" class="elsevierStylePara elsevierViewall">In cadaver studies of 73 wrists with a mean age of 84 years, Bhatia et al.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a> found, scaphotrapeziotrapezoid osteoarthritis in 83% of the cases, with different levels of involvement of the trapeziometacarpal joint.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> However, Brown et al.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a> suggest there is poor correlation between arthritis found radiographically and that present in cadaver dissections. There is an estimated 11% prevalence of clinically symptomatic isolated STT arthritis, making this a rare disorder.<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">2,10,11</span></a> However its real incidence is as yet unknown,<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">1,4,5,9,12</span></a> and is believed to exceed that which is clinically apparent.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">5,13</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The disorder was characterised and staged radiographically in 1978 by Crosby et al.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a>, and subsequently in 2010 by White et al.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The initial therapeutic approach is symptomatic, by analgesic treatment, local infiltrations and the use of orthosis. Surgery is a last resort when conservative treatment has failed.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Because the role of the STT joint in the biomechanics of the wrist and thumb<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> is unknown, the surgical approach to the condition poses a challenge to orthopaedic surgeons.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The complications of STT arthrodesis,<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> the most widely used procedure, and resection of the distal scaphoid,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> have lead to the development of new surgical alternatives, with a view to improving the outcomes of traditional intervention, and achieve the difficult balance between eliminating pain without sacrificing strength or thumb movement, and avoid causing carpal destabilisation.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The most frequent interventions include distal scaphoid resection and tendon interposition,<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a> pyrocarbon implants,<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">11,16</span></a> trapeziectomy and ligament reconstruction and tendon interposition<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17,18</span></a> together with partial trapezoidal resection<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> and even arthroscopic procedures.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The aim of this study was to present the clinical, radiological and functional outcomes using resurfacing arthroplasty with scaphoid anchorage, in the treatment of isolated STT arthritis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and method</span><p id="par0045" class="elsevierStylePara elsevierViewall">We undertook an observational, longitudinal and retrospective study (level IV) from 2013 to the present date, to evaluate the results obtained in patients with isolated STT, surgically treated by STT resurfacing arthroplasty with scaphoid anchorage, between 2013 and 2015.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The inclusion criterion in selecting the study sample was the presence of clinically symptomatic STT refractory to conservative treatment, and associated trapeziometacarpal joint arthritis was the exclusion criterion.</p><p id="par0055" class="elsevierStylePara elsevierViewall">All the patients underwent a preoperative protocol and post-operative follow-up (immediate, at 3 months and once a year from placement of the implant), along with a complete clinical and radiographic study (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1–3</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Ten patients were assessed–8 women (80%) and 2 men (20%)–with isolated STT arthritis treated surgically using resurfacing arthroplasty with scaphoid anchorage (INCA), with a mean age of 65 (56–74) all right handed, of whom 7 (70%) were manual workers. The dominant side was operated in 7 (70%) of the patients.</p><p id="par0065" class="elsevierStylePara elsevierViewall">All the patients had pain in the region of the STT, at the radio-palmar aspect of the wrist, which became worse on gripping and pinching activities, and reduced strength compared to the contralateral side.</p><p id="par0070" class="elsevierStylePara elsevierViewall">There was no history of trauma in any case. The mean period from the onset of symptoms until surgery was 16 (6–30) months.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Seven of the 10 (70%) patients had bilateral isolated STT arthritis revealed on x-ray, which in all cases was a grade 1 according to Crosby et al.,<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a> and 6 out of 10 cases (60%) had carpal tunnel syndrome.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The INCA prosthesis, cobalt-chromium-molybdenum alloy and bilayer coating of pure porous titanium and hydroxyapatite, was used as the implant in all cases (Lépine, France).</p><p id="par0085" class="elsevierStylePara elsevierViewall">All the patients were treated as outpatients by the same surgeon and the same surgical team, using loco-regional anaesthesia and ischaemia (antebrachial tourniquet) of the affected limb. All the patients received prophylactic antibiotics.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Surgical technique</span><p id="par0090" class="elsevierStylePara elsevierViewall">A dorsal radial approach is used with a transversal skin incision over the STT joint. The sensitive branch of the radial nerve and the radial artery are systematically located, and separated and protected. The STT joint capsule exposure is located through the interval between the tendon of the extensor carpi radialis brevis and extensor pollicus longus (ulnarly retracted) and the extensor ollicis brevis (radially retracted). The arthroplasty is performed transversally, preserving the capsular flaps for subsequent closure, and the STT joint accessed performing the osteotomy of the distal scaphoid perpendicular to its longitudinal axis, of approximately 3<span class="elsevierStyleHsp" style=""></span>mm (<a class="elsevierStyleCrossRefs" href="#fig0020">Figs. 4 and 5</a>), respecting the proximal insertion of the dorsal lateral scaphotrapezial ligaments and the anteromedial stout scaphotrapezial ligament.<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">21,22</span></a></p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">The surface of the distal scaphoid cut is considered when selecting the correct implant size, and tests of the 3 sizes available were made (14/10, 16/11, 18/12) (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). Then, after placing the implant, its mobility and stability is checked, closure is by layers, reconstructing the joint capsule and the skin closure with resorbable suture.</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">All patients are immobilised by palmar plaster splint, including the wrist and the thumb column for 3 weeks, and then passive and active mobilisation is started.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The wrist's range of motion is assessed by standard goniometry, with axes centred over the third metacarpal and radial diaphysis as a reference.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Thumb mobility is measured by standard goniometry from the neutral position of the pain (10° abduction and 30° antepulsion with respect to the axis of the forearm), according to the IFSSH criteria.<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> Opposition is determined using the Kapandji<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> test, with values from 1 to 10 depending where the distal end of the thumb reached in maximum opposition. Comparison is made with the contralateral side.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Strength is measured in a standardised way using a Jamar Hidraulic Hand Dynamometer with the patient seated, with their arm by the side of the body, elbow flexed 90° and the forearm in neutral rotation.</p><p id="par0120" class="elsevierStylePara elsevierViewall">We used the visual analogue scale (VAS) for clinical assessment of pain, where 0 represented no pain and 10 continual or unbearable pain, and the patients’ functional outcomes and satisfaction were measured using the DASH questionnaire.<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Radiographic analysis of the patients comprised 3 projections (anteroposterior, lateral and oblique) of both wrists, enabling the extent of STT osteoarthritis to be determined, according to the classification of Crosby et al.,<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a> and adequate assessment of the axes represented by the scaphoid, semilunar and large bones, which enabled us to measure the scapholunate and large semilunar angles radiographically.</p><p id="par0130" class="elsevierStylePara elsevierViewall">The angle made by the lines forming the axis of the semilunar and scaphoid represents the scapholunate angle, for which we take values between 30° and 60° as the normality reference. The semilunar large angle is the combination of the axis of the semilunar and the large bone, assuming normality values of between 0° and 15°.<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">The mean postoperative follow-up period was 26 (12–50) months.</p><p id="par0140" class="elsevierStylePara elsevierViewall">There were no losses to follow-up.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0145" class="elsevierStylePara elsevierViewall">The INCA prosthesis was used in 10 patients. The associated carpal tunnel syndrome was operated during the same intervention in the 6 patients with the condition.</p><p id="par0150" class="elsevierStylePara elsevierViewall">The mean surgery time was 41 (40–45) minutes, the most used implant size was 14 – up to 8 times – and a size 16 was used in the other 2 patients. There were no complications during the surgical procedure.</p><p id="par0155" class="elsevierStylePara elsevierViewall">The wrist's range of motion in terms of extension was a mean of 73° (65–80°), 96% compared to the contralateral wrist; mean flexion was 61° (95%), mean ulnar tilt was 22° (87%) and radial tilt 18° (91%). In terms of thumb mobility, the mean antepulsion was 22° (20–24°), mean retropulsion 28° (21°–30°), mean abduction 31° (22°–40°) and mean adduction 21° (17–25°). Opposition according to Kapandji's<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> scale was 10 in all the patients.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Grip and index finger terminolateral pinch strength evolved more gradually and progressively, with a mean grip strength of 19.3<span class="elsevierStyleHsp" style=""></span>kg (95%) and the mean pinch strength was 5.4<span class="elsevierStyleHsp" style=""></span>kg (95%) compared with the contralateral side (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">The placement of the implant in the distal scaphoid, by increasing its height, caused a change in carpal alignment. Radiographic measurement showed mean scapholunate angle values of 52° (33°–65°), the mean postoperative angle being 31°(14°–52°). The mean preoperative semilunar-large angle was 8° (4°–13°), the mean postoperative angle being 10° (4°–14°).</p><p id="par0170" class="elsevierStylePara elsevierViewall">All the patients returned to their daily activities in the first 3 months after the operation. Likewise all the patients had improved subjective assessment of pain score (VAS), with a preoperative mean of 8.1 (7–9) and a postoperative mean of 2.1 (0–3). Functional assessment using the DASH questionnaire showed a postoperative mean of 16 (2–28), and all the patients were satisfied with the surgical intervention.</p><p id="par0175" class="elsevierStylePara elsevierViewall">Temporary irritation of the sensitive branch of the radial nerve was a postoperative complication. This occurred in 2 of the 10 patients operated (20%) and the symptoms completely resolved within the first 6 postoperative weeks. There were no dislocations, osteolytic changes or loosening of the implant.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0180" class="elsevierStylePara elsevierViewall">Uncertainty remains as to the participation of the STT joint in arthritis and the biomechanics of the wrist and thumb joint.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">2</span></a> The difficulty of clinically identifying the condition and its low incidence, together with therapeutic outcomes that do not achieve adequate balance in terms of strength, mobility and progression of the disorder, keep the debate about the different forms of treatment open.<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">The use of scaphoid anchorage implants is a novel form of treatment for isolated STT arthritis. The references in the literature to this form of treatment are few but satisfactory. An example of this is the results presented by Teissier and Daumillare<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> on a total of 15 patients, with a mean follow-up of 39 months in 2015.</p><p id="par0190" class="elsevierStylePara elsevierViewall">The results of our study show that after 26 months’ mean follow-up the patients experienced major clinical and functional improvement, and were able to resume their working and daily activities promptly – within the first 3 months.</p><p id="par0195" class="elsevierStylePara elsevierViewall">The epidemiological results of the study are similar to those found in the literature, the condition being more frequent in females, and predominating in the sixth decade of life.</p><p id="par0200" class="elsevierStylePara elsevierViewall">Recovery of range of motion was the first variable to show improvement, a recovery of motion above 90% was achieved, with the exception of ulnar tilt, with 87% recovery, still higher than that found in other studies (75% with the pyrocarbon implant: Low and Edmunds<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a>; 82% with STT arthrodesis: Watson et al.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">29</span></a>; 85% with distal scaphoid resection: Garcia-Elias et al.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> (see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, modified from Low and Edmunds).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0205" class="elsevierStylePara elsevierViewall">Recovery of strength, achieving values of up to 95% for grip strength and 95% for grip strength, was the last parameter to recover, and occasionally exceeded the strength of the contralateral hand. The strength values obtained are satisfactory and comparable to those obtained with other forms of treatment (see <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, modified from Low and Edmunds), with the exception of presented by Langenhan et al.,<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a> where recovery of strength by trapeziectomy, ligament reconstruction and tendon interposition achieved recovery of grip and pinch strength of up to 100% compared to the other side.</p><p id="par0210" class="elsevierStylePara elsevierViewall">Scaphoid fixation of the implant, together with the integration achieved thanks to the hydroxyapatite coating, provide stability to the implant. This fact is essential to maintain joint congruence and firmness over the radial column, preserving mobility at mediocarpal level. Thus, the complication of prosthetic dislocation, which occurs in interposition arthroplasty without scaphoid anchorage, as described with the use of pyrocarbon implants.<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">11,16</span></a> However, we do not rule out the onset of other complications subsidiary to the implant used in our study, which have not occurred to date, but long-term follow-up must be continued.</p><p id="par0215" class="elsevierStylePara elsevierViewall">Correct placement of the implant at scaphoid level, despite being more technically easy than other procedures, is a factor that can change patients’ clinical and functional outcomes. It is important to regain scaphoid length and make a correct choice of implant size without causing pinching between the prosthesis and the proximal trapezio-trapezoid joint.</p><p id="par0220" class="elsevierStylePara elsevierViewall">Interposition arthroplasty<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a> has been used to prevent progression and carpal destabilisation caused by resection of the distal scaphoid,<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> its arthroscopic excision<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">20</span></a> and even procedures where osteotomy is not performed at the level of the scaphoid, such as trapeziectomy and ligament reconstruction and tendon interposition,<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">17,18</span></a> or its association with partial trapeziectomy,<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> with satisfactory outcomes. Its use does not prevent progression of the deformity to DISI, as Rectenwald et al.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">30</span></a> (in two cases) after a trapezoidectomy of almost 50%, for pantrapezial arthritis. When Andrachuk and Yang,<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">19</span></a> excised a third of the proximal trapezoid without causing carpal destabilisation. Even in cases of trapeziectomy for trapeziometacarpal arthritis the deformity progresses to DISI, especially in patients with STT arthritis.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">31</span></a> STT arthritis sometimes presents associated with a pattern of DISI. It is not known whether this is caused by STT arthritis or whether instability causes the STT arthritis. In this situation, the risk of radiographic progression of instability is greater, therefore sufficient graft should be put into the scaphoid to ensure its length is maintained when an arthroplasty is used, and carpal destabilisation should be anticipated and prevented, when resection techniques, scaphoid arthoplasty and trapeziectomies are performed, and additional carpal stabilisation procedures should be considered.<a class="elsevierStyleCrossRefs" href="#bib0260"><span class="elsevierStyleSup">19,32,33</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">The principal advantage of this implant lies in restoring the original carpal kinematics and preventing the progression of poor alignment to DISI, which could be caused by maintenance of the height of the scaphoid by the implant. At the current time of follow-up no radiographic or clinical signs of progression to carpal collapse have been encountered. However, studies with more patients and a longer follow-up period are necessary to identify and prevent this problem.</p><p id="par0230" class="elsevierStylePara elsevierViewall">Among the complications that appeared during follow-up was the onset of paraesthesia in the territory of the sensitive branch of the radial nerve in 2 patients, in one case functional recovery started insidiously, and complete resolution of symptoms occurred within the first 6 postoperative weeks.</p><p id="par0235" class="elsevierStylePara elsevierViewall">The satisfactory results achieved in the study show that INCA prostheses are a good alternative for treating isolated and symptomatic arthritis.</p><p id="par0240" class="elsevierStylePara elsevierViewall">This study seeks to show the results achieved with a novel technique in treating a disorder that is difficult to treat.</p><p id="par0245" class="elsevierStylePara elsevierViewall">The study had limitations in terms of its methodological characteristics. Comparison with the contralateral wrist, where we found an incidence of STT arthritis of the lowest Crosby grade, in up to 70% of cases, and the lack of references on coated arthroplasties in this disorder mean it is necessary to compare results with different forms of treatment.</p><p id="par0250" class="elsevierStylePara elsevierViewall">More prospective and randomised research studies are considered necessary, and comparison with different forms of treatment. Further studies should include a larger number of patients with a longer follow-up period.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Level of evidence</span><p id="par0255" class="elsevierStylePara elsevierViewall">Level of evidence IV.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical responsibilities</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Protection of people and animals</span><p id="par0260" class="elsevierStylePara elsevierViewall">The authors declare that neither human nor animal testing have been carried out under this research.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Data confidentiality</span><p id="par0265" class="elsevierStylePara elsevierViewall">The authors declare that they have complied with their work centre protocols for the publication of patient data.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Privacy rights and informed consent</span><p id="par0270" class="elsevierStylePara elsevierViewall">The authors declare that no patients’ data appear in this article.</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of interests</span><p id="par0275" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres941136" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec914353" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres941135" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec914354" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and method" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Surgical technique" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Level of evidence" ] 9 => array:3 [ "identificador" => "sec0035" "titulo" => "Ethical responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Privacy rights and informed consent" ] ] ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflict of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-11-06" "fechaAceptado" => "2017-05-22" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec914353" "palabras" => array:4 [ 0 => "Prostheses and implants" 1 => "Wrist joint" 2 => "Carpal bones" 3 => "Osteoarthritis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec914354" "palabras" => array:4 [ 0 => "Prótesis e implantes" 1 => "Articulación de la muñeca" 2 => "Huesos del carpo" 3 => "Osteoartritis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study is to show the results of scaphotrapeziotrapezoid (STT) joint osteoarthritis treatment performing resurfacing arthroplasty with scaphoid anchorage.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An observational, descriptive and retrospective study was performed. Ten patients with isolated STT joint osteoarthritis were studied between 2013 and 2015. The mean follow-up time was 26<span class="elsevierStyleHsp" style=""></span>months. Clinical results, functional and subjective scores were reviewed.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The patients were satisfied, achieving an average of 2.1 (0–3) on the VAS score and 16 (2 to 28) in the DASH questionnaire, and returning to work in the first three months post-surgery. Recovery of range of motion compared to the contralateral wrist was 96% in extension, 95% in flexion, 87% in ulnar deviation and 91% in radial deviation. The average handgrip strength of the wrist was 95% and pinch strength was 95% compared to the contralateral side. There were no intraoperative complications or alterations in postoperative carpal alignment.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Resurfacing arthroplasty is proposed as a good and novel alternative in treating isolated SST joint arthritis. Achieving the correct balance between the strength and mobility of the wrist, without causing carpal destabilisation, is important to obtain satisfactory clinical and functional results.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and method" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El propósito de este estudio es mostrar los resultados obtenidos con el empleo de la artroplastia de recubrimiento con anclaje escafoideo en el tratamiento de la artrosis escafotrapeciotrapezoidea (ETT) aislada.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realiza un estudio observacional, descriptivo y retrospectivo del tratamiento de 10 pacientes con artrosis ETT aislada sintomática durante los años 2013 a 2015. El seguimiento medio es de 26<span class="elsevierStyleHsp" style=""></span>meses (12-50). Se han evaluado los resultados clínicos, los funcionales y la satisfacción del paciente.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes se encuentran satisfechos, obteniendo una media de 2,1 (0-3) en la escala VAS y de 16 (2-28) en el cuestionario DASH, reincorporándose a las actividades laborales en los primeros 3<span class="elsevierStyleHsp" style=""></span>meses posquirúrgicos. La recuperación del arco de movilidad en comparación con la muñeca contralateral es del 96% en extensión, del 95% en flexión, del 87% en inclinación cubital y del 91% en inclinación radial. La fuerza puño media es del 95% y la fuerza de pinza, del 95%, en comparación con el lado contralateral. No han surgido complicaciones intraoperatorias ni alteraciones en la alineación carpiana posquirúrgicas.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La artroplastia de recubrimiento con anclaje escafoideo supone una alternativa novedosa y satisfactoria en el tratamiento de la artrosis ETT aislada. Lograr un balance adecuado entre la fuerza y la movilidad de la muñeca, sin producir una desestabilización carpiana, es importante para obtener resultados clínicos y funcionales satisfactorios.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y método" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Humada Álvarez G, Simón Pérez C, García Medrano B, Faour Martín O, Marcos Rodríguez JJ, Vega Castrillo A, et al. Tratamiento de la artrosis escafotrapeciotrapezoidea aislada con artroplastia de recubrimiento con anclaje escafoideo. Rev Esp Cir Ortop Traumatol. 2017;61:412–418.</p>" ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1179 "Ancho" => 800 "Tamanyo" => 75300 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Preoperative posteroanterior radiography of left wrist; scaphotrapeziotrapezoid arthritis grade III according to the classification by Crosby et al.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a></p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 900 "Ancho" => 900 "Tamanyo" => 85753 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Intraoperative radiographic image confirming the appropriate placement of the implant.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1257 "Ancho" => 800 "Tamanyo" => 96256 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Postoperative posteroanterior radiography of the left wrist of 36 months’ evolution.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 658 "Ancho" => 950 "Tamanyo" => 174551 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Approach used and protection of the vasculonervous component. The osteotomy line is made at the level of the distal scaphoid.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 559 "Ancho" => 950 "Tamanyo" => 174432 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Resected piece of the distal scaphoid.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 686 "Ancho" => 950 "Tamanyo" => 147599 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Placement of the scaphotrapeziotrapezoid joint with anchorage at the level of the scaphoid.</p>" ] ] 6 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Operated side \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Contralateral side \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% compared to the contralateral side \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Extension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">73° (65–80°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">76° (70–80°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">96% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Flexion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">61° (55–70°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64° (55–70°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Radial tilt \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">18° (14–21°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20° (16–22°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">91% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ulnar tilt \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22° (20–26°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26° (22–28°) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">87% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wrist strength \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">19.3<span class="elsevierStyleHsp" style=""></span>kg (9.98–31.5<span class="elsevierStyleHsp" style=""></span>kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20.4<span class="elsevierStyleHsp" style=""></span>kg (9.07–39.3<span class="elsevierStyleHsp" style=""></span>kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pinch strength \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.4<span class="elsevierStyleHsp" style=""></span>kg (2.5–10.2<span class="elsevierStyleHsp" style=""></span>kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.7<span class="elsevierStyleHsp" style=""></span>kg (2.1–9<span class="elsevierStyleHsp" style=""></span>kg) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1592779.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Sample of the results achieved in terms of mobility and strength, for the operated side, the contralateral side and their comparison expressed as a percentage.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Coated arthroplasty (this study, 2016) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pyrocarbon implant (Low and Edmunds, 2007) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">STT Arthrodesis (Watson et al., 2003) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Distal scaphoid resection (Garcia-Elias et al., 1999) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Number of patients \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">59 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Mean follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">26 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">16 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">42 months \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Extension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">96% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">90% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">80% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">88% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Flexion \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">92% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">79% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Radial tilt \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">91% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">64% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">81% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Ulnar tilt \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">87% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">75% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">82% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Wrist strength \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">82% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">77% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">83% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pinch strength \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">85% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">95% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">93% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1592778.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Comparison between four studies showing different treatment forms for scaphotrapeziotrapezoid, modified from Low and Edmunds.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:33 [ 0 => array:3 [ "identificador" => "bib0170" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The SLAC wrist: Scapholunate advanced collapse pattern of degenerative arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Watson" 1 => "F. Ballet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "1984" "volumen" => "9" "paginaInicial" => "358" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6725894" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0175" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoarthritis of the wrist STT joint and radiocarpal joint" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Wollstein" 1 => "J. Clavijo" 2 => "L.A. Gilula" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis" "fecha" => "2012" "volumen" => "2012" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0180" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of degenerative arthritis of the base of the thumb in post-menopausal women" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Armstrong" 1 => "J. Hunter" 2 => "T. Davis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg J Br" "fecha" => "1994" "volumen" => "19" "paginaInicial" => "340" "paginaFinal" => "341" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0185" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scaphotrapezial trapezoidal arthrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.B. Crosby" 1 => "R.L. Linscheid" 2 => "J.H. Dobyns" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "1978" "volumen" => "3" "paginaInicial" => "223" "paginaFinal" => "234" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/659818" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0190" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence and distribution of scaphotrapezotrapezoidal arthritis in 73 fresh cadaveric wrists" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Bhatia" 1 => "T. Pisoh" 2 => "C. Touam" 3 => "C. Oberlin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Chir Main Memb Super" "fecha" => "1996" "volumen" => "15" "paginaInicial" => "220" "paginaFinal" => "225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9001108" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0195" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Degenerative joint disease of the trapezium: a comparative radiographic and anatomic study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. North" 1 => "R. Eaton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "1983" "volumen" => "8" "paginaInicial" => "160" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6833724" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0200" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resection of the distal scaphoid for scaphotrapeziotrapezoid osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Garcia-Elias" 1 => "A.L. Lluch" 2 => "A. Farreres" 3 => "F. Castillo" 4 => "P.H. Saffar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1054/jhsb.1999.0169" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Br" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "448" "paginaFinal" => "452" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10473155" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0205" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of scaphotrapezio-trapezoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Wolf" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hcl.2008.03.002" "Revista" => array:6 [ "tituloSerie" => "Hand Clin" "fecha" => "2008" "volumen" => "24" "paginaInicial" => "301" "paginaFinal" => "306" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18675722" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0210" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiography and visual pathology of the osteoarthritic scaphotrapezio-trapezoidal joint, and its relationship to trapeziometacarpal osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.D. Brown 3rd" 1 => "M.S. Roh" 2 => "R.J. Strauch" 3 => "M.P. Rosenwasser" 4 => "G.A. Ateshian" 5 => "V.C. Mow" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2003" "volumen" => "28" "paginaInicial" => "739" "paginaFinal" => "743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14507501" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0215" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osteoarthritis of the scaphotrapezial joint" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. Lim" 1 => "P. Dieppe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Rheumatol" "fecha" => "1994" "volumen" => "33" "paginaInicial" => "1142" "paginaFinal" => "1144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8000743" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0220" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Isolated scaphotrapeziotrapezoid osteoarthritis: preliminary results of treatment using a pyrocarbon implant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.K. Low" 1 => "I.A. Edmunds" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1142/S0218810407003523" "Revista" => array:6 [ "tituloSerie" => "Hand Surg" "fecha" => "2007" "volumen" => "12" "paginaInicial" => "73" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18098356" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0225" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification system for isolated arthritis of the scaphotrapeziotrapezoidal joint" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. White" 1 => "J. Clavijo" 2 => "L.A. Gilula" 3 => "R. Wollstein" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Plast Surg Hand Surg" "fecha" => "2010" "volumen" => "44" "paginaInicial" => "112" "paginaFinal" => "117" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0230" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The scaphotrapezio-trapezoidal joint. Part 1: An anatomic and radiographic study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Moritomo" 1 => "S.F. Viegas" 2 => "K. Nakamura" 3 => "M.F. DaSilva" 4 => "R.M. Patterson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/jhsu.2000.4582" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2000" "volumen" => "25" "paginaInicial" => "899" "paginaFinal" => "910" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11040305" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0235" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scaphotrapeziotrapezoid arthrodesis for arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Wollstein" 1 => "H. Watson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hcl.2005.08.001" "Revista" => array:6 [ "tituloSerie" => "Hand Clin" "fecha" => "2005" "volumen" => "21" "paginaInicial" => "539" "paginaFinal" => "543" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16274863" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0240" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Excisional arthroplasty for scaphotrapeziotrapezoidal osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Garcia-Elias" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsa.2010.12.016" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2011" "volumen" => "36" "paginaInicial" => "516" "paginaFinal" => "520" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21371628" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0245" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scaphotrapeziotrapezoid joint arthritis: a pilot study of treatment with the scaphoid trapezium pyrocarbon implant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Pegoli" 1 => "I.P. Zorli" 2 => "G. Pivato" 3 => "G. Berto" 4 => "G. Pajardi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsb.2006.05.006" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Br" "fecha" => "2006" "volumen" => "31" "paginaInicial" => "569" "paginaFinal" => "573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16875763" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0250" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current trends in nonoperative and operative treatment of trapeziometacarpal osteoarthritis: a survey of US hand surgeons" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Wolf" 1 => "S. Delaronde" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsa.2011.10.010" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2012" "volumen" => "37" "paginaInicial" => "77" "paginaFinal" => "82" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22119601" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0255" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trapeziectomy and ligament reconstruction tendon interposition for isolated scaphotrapeziotrapezoid osteoarthritis of the wrist" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Langenhan" 1 => "B. Hohendorff" 2 => "A. Probst" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1753193413514500" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Eur Vol" "fecha" => "2013" "volumen" => "39" "paginaInicial" => "833" "paginaFinal" => "837" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24334602" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0260" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Modified total trapezial and partial trapezoidal excision and ligament reconstruction tendon interposition reduces symptoms in isolated scaphotrapezial-trapezoid arthritis of the wrist" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Andrachuk" 1 => "S.S. Yang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1753193411434718" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Eur Vol" "fecha" => "2012" "volumen" => "37" "paginaInicial" => "637" "paginaFinal" => "641" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22570323" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0265" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Arthroscopic treatment of scaphotrapeziotrapezoid osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C. Mathoulin" 1 => "F. Darin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.hcl.2011.05.001" "Revista" => array:6 [ "tituloSerie" => "Hand Clin" "fecha" => "2011" "volumen" => "27" "paginaInicial" => "319" "paginaFinal" => "322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21871354" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0270" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The scaphotrapezial ligament complex: an anatomic and biomechanical study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Drewniany" 1 => "A.K. Palmer" 2 => "A.E. Flatt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "1985" "volumen" => "10" "paginaInicial" => "492" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4020059" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0275" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Kinetic analysis of carpal stability during grip" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Garcia-Elias" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hand Clin" "fecha" => "1997" "volumen" => "13" "paginaInicial" => "151" "paginaFinal" => "158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9048190" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0280" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Terminology for Hand Surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "Atlas de anatomía de superficie y de movilidad articular" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "IFSSH, International Federation of Societies for Surgery of the Hand" "fecha" => "2001" "volumen" => "5" "paginaInicial" => "108" "paginaFinal" => "113" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0285" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cotation clinique de l’opposition et de la contrapposition du pouce" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Kapandji" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Chir Main Memb Super" "fecha" => "1986" "volumen" => "5" "paginaInicial" => "67" "paginaFinal" => "73" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0290" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Versión española del cuestionario DASH. Adaptacio¿n transcultural, fiabilidad, validez y sensibilidad a los cambios" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.T. Hervas" 1 => "M.J. Navarro" 2 => "S. Peiro" 3 => "J.L. Rodrigo" 4 => "P. Lopez" 5 => "I. Martinez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin" "fecha" => "2006" "volumen" => "127" "paginaInicial" => "441" "paginaFinal" => "447" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0295" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inestabilidad del carpo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Garcia-Elias" 1 => "W. Geissler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Cirugía de la mano" "paginaInicial" => "535" "paginaFinal" => "604" "edicion" => "5th ed." "serieFecha" => "2007" ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0300" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The surgical treatment of scaphotrapeziotrapezoid osteoarthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Kozin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Hand Clin" "fecha" => "2001" "volumen" => "17" "paginaInicial" => "303" "paginaFinal" => "314" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11478052" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0305" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traitement de l’arthrose STT par un implant de resurfaçage scaphoïdien" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Teissier" 1 => "A. Daumillare" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Chir Main" "fecha" => "2015" "volumen" => "34" "paginaInicial" => "354" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0310" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scaphotrapeziotrapezoid arthrodesis: a follow-up study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.K. Watson" 1 => "R. Wollstein" 2 => "E. Joseph" 3 => "R. Manzo" 4 => "J. Weinzweig" 5 => "D. Ashmead 4th." ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/jhsu.2003.50072" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2003" "volumen" => "28" "paginaInicial" => "397" "paginaFinal" => "404" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12772094" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0315" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Symptomatic carpal collapse after trapeziectomy and partial trapeziodectomy: report of two cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Rectenwald" 1 => "D. Green" 2 => "J. Dobyns" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsa.2005.01.017" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2005" "volumen" => "30" "paginaInicial" => "706" "paginaFinal" => "710" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16039362" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0320" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trapeziectomy and carpal collapse" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Yuan" 1 => "S. Moran" 2 => "S. Tay" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsa.2008.11.007" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2009" "volumen" => "34" "paginaInicial" => "219" "paginaFinal" => "227" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19181222" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0325" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carpometacarpal and scaphotrapeziotrapezoid arthritis: arthroscopy, arthroplasty, and arthrodesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.V. Kapoutsis" 1 => "A. Dardas" 2 => "C.S. Day" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Hand Surg" "fecha" => "2011" "volumen" => "36" "paginaInicial" => "354" "paginaFinal" => "366" ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0330" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The clinical implications of scaphotrapezium-trapezoidal arthritis with associated carpal instability" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Tay" 1 => "S. Moran" 2 => "A. Shin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jhsa.2006.10.021" "Revista" => array:6 [ "tituloSerie" => "J Hand Surg Am" "fecha" => "2007" "volumen" => "32" "paginaInicial" => "47" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17218175" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/19888856/0000006100000006/v1_201711201646/S1988885617300810/v1_201711201646/en/main.assets" "Apartado" => array:4 [ "identificador" => "7577" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/19888856/0000006100000006/v1_201711201646/S1988885617300810/v1_201711201646/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1988885617300810?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 2 | 8 |
| 2024 October | 56 | 30 | 86 |
| 2024 September | 82 | 25 | 107 |
| 2024 August | 52 | 11 | 63 |
| 2024 July | 57 | 10 | 67 |
| 2024 June | 39 | 11 | 50 |
| 2024 May | 43 | 14 | 57 |
| 2024 April | 42 | 15 | 57 |
| 2024 March | 49 | 10 | 59 |
| 2024 February | 92 | 26 | 118 |
| 2024 January | 117 | 23 | 140 |
| 2023 December | 108 | 36 | 144 |
| 2023 November | 100 | 33 | 133 |
| 2023 October | 117 | 47 | 164 |
| 2023 September | 61 | 11 | 72 |
| 2023 August | 62 | 17 | 79 |
| 2023 July | 86 | 36 | 122 |
| 2023 June | 82 | 30 | 112 |
| 2023 May | 139 | 33 | 172 |
| 2023 April | 102 | 26 | 128 |
| 2023 March | 84 | 29 | 113 |
| 2023 February | 76 | 30 | 106 |
| 2023 January | 73 | 31 | 104 |
| 2022 December | 60 | 32 | 92 |
| 2022 November | 54 | 53 | 107 |
| 2022 October | 29 | 21 | 50 |
| 2022 September | 37 | 32 | 69 |
| 2022 August | 34 | 27 | 61 |
| 2022 July | 33 | 34 | 67 |
| 2022 June | 35 | 31 | 66 |
| 2022 May | 40 | 41 | 81 |
| 2022 April | 41 | 33 | 74 |
| 2022 March | 68 | 33 | 101 |
| 2022 February | 47 | 34 | 81 |
| 2022 January | 75 | 43 | 118 |
| 2021 December | 49 | 32 | 81 |
| 2021 November | 37 | 51 | 88 |
| 2021 October | 60 | 38 | 98 |
| 2021 September | 81 | 57 | 138 |
| 2021 August | 56 | 33 | 89 |
| 2021 July | 53 | 26 | 79 |
| 2021 June | 17 | 18 | 35 |
| 2021 May | 21 | 25 | 46 |
| 2021 April | 49 | 30 | 79 |
| 2021 March | 15 | 26 | 41 |
| 2021 February | 13 | 17 | 30 |
| 2021 January | 11 | 10 | 21 |
| 2020 December | 0 | 1 | 1 |
| 2018 July | 1 | 0 | 1 |
| 2018 April | 1 | 0 | 1 |
Show all
