Our Summary

This research paper looks at a fairly new type of surgery called Arthroscopic Scaphotrapeziotrapezoid (STT) Fusion (ASTTF) that is less invasive than traditional open surgery. In this study, the researchers reviewed medical records and radiological data of patients who had undergone ASTTF between 2014 and 2022 in two major hospitals.

They found that four out of five patients who underwent ASTTF surgery achieved successful fusion. On average, patients were able to regain 70% of their grip strength, and 86% of their extension and 93% of their flexion in their wrists compared to the other hand. The average follow-up time after the surgery was 18 months. One patient (20%) had to have a second operation two years after the initial surgery due to non-union of the STT.

The study concluded that while ASTTF is a technically challenging procedure that requires a significant amount of practice and time to master, it is less invasive than traditional open surgery and has similar results. However, more research is needed to compare the benefits and results of open surgery and ASTTF in a controlled study.

FAQs

  1. What is Arthroscopic Scaphotrapeziotrapezoid (STT) Fusion (ASTTF) surgery and how is it different from traditional open surgery?
  2. What were the main findings of the study on patients who had undergone ASTTF surgery between 2014 and 2022?
  3. Does the study suggest that ASTTF is as effective as traditional open surgery, and what further research is needed?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow post-operative care instructions carefully to promote proper healing and recovery. This may include keeping the hand elevated, performing prescribed exercises, attending physical therapy sessions, and avoiding activities that could strain the hand. It is important to communicate any concerns or changes in symptoms to the doctor to ensure the best possible outcome.

Suitable For

Patients who are typically recommended hand surgery include those with conditions such as arthritis, carpal tunnel syndrome, tendon injuries, nerve compression syndromes, fractures, and deformities. Hand surgery may be recommended when conservative treatments have not been effective in relieving symptoms or improving function. In some cases, hand surgery may also be recommended to prevent further damage or complications. It is important for patients to consult with a hand surgeon to determine the most appropriate treatment plan for their specific condition.

Timeline

Before hand surgery:

  • Patient experiences pain, limited range of motion, and difficulty performing daily activities due to a hand injury or condition.
  • Patient consults with a hand surgeon to discuss treatment options and determine if surgery is necessary.
  • Patient undergoes pre-operative assessments, such as blood tests, imaging studies, and physical exams, to ensure they are a suitable candidate for surgery.
  • Patient receives pre-operative instructions, including fasting guidelines, medication management, and anesthesia options.

After hand surgery:

  • Patient undergoes ASTTF surgery, a less invasive procedure that involves fusing the STT joint in the wrist using arthroscopic techniques.
  • Patient is monitored closely post-operatively for any complications, such as infection, swelling, or nerve damage.
  • Patient undergoes physical therapy and rehabilitation to regain strength, range of motion, and function in their hand.
  • Patient attends follow-up appointments with their surgeon to monitor healing progress and address any concerns or complications.
  • Patient gradually resumes normal activities and may experience improved grip strength, flexion, and extension in their hand over time.
  • Patient may need additional surgeries or treatments if complications arise or if fusion is not successful.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hand surgery, specifically ASTTF, include:

  1. What are the potential risks and complications associated with ASTTF surgery?
  2. What is the success rate of ASTTF surgery compared to traditional open surgery?
  3. How long is the recovery process after ASTTF surgery?
  4. Will I need physical therapy or rehabilitation after ASTTF surgery?
  5. How soon after the surgery can I expect to regain full function and strength in my hand?
  6. Are there any restrictions or limitations on activities I should follow after ASTTF surgery?
  7. How often will I need follow-up appointments to monitor my progress after ASTTF surgery?
  8. What is the likelihood of needing a second surgery or revision after ASTTF surgery?
  9. Are there any alternative treatments or procedures that I should consider before undergoing ASTTF surgery?
  10. Can you provide me with information or resources to help me better understand the ASTTF procedure and what to expect before, during, and after surgery?

Reference

Authors: Myllykoski J, Räisänen MP, Kotkansalo T, Juntunen M, Pääkkönen M. Journal: J Hand Surg Asian Pac Vol. 2023 Oct;28(5):580-586. doi: 10.1142/S2424835523500613. Epub 2023 Oct 27. PMID: 37905364