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OBJETIVO: Avaliar prospectivamente os resultados de uma série de pacientes submetidos ao tratamento cirúrgico da rizartrose, com a técnica de ressecção do trapézio associada à interposição de um novelo do tendão abdutor longo do polegar. MÉTODOS: De maio a agosto de 2005, 10 pacientes foram submetidos ao tratamento cirúrgico da rizartrose. Foram incluídos pacientes com osteoartrose primária da articulação trapézio-metacárpica, estágios II, III, IV da classificação de Eaton, com dor persistente refratária ao tratamento clínico. Para avaliação funcional foi utilizada a escala visual analógica, questionário DASH e o escore de Buck-Gramcko. Na avaliação global do paciente foram mensuradas as forças de preensão palmar, pinça polpa a polpa, pinça lateral, pinça de três pontos, oponência e abduções radial e palmar. Realizou-se, ainda, o índice de migração do primeiro metacarpal na radiografia de repouso e sob estresse. RESULTADOS: Foram considerados bons, no alívio da dor (p = 0,005), com melhora da função na avaliação pelo DASH módulos 2 (p = 0,02) e 3 (p = 0,022) O escore de Buck-Gramcko apresentou um resultado excelente e três ótimos. Houve melhora em quase toda avaliação global, sendo não significante apenas na pinça lateral e abdução. Em todos pacientes houve migração do primeiro metacarpal. CONCLUSÃO: A trapeziectomia associada à interposição de um novelo do tendão abdutor longo do polegar mostrou-se uma técnica de execução relativamente simples e eficaz no alívio da dor e na melhora funcional.OBJECTIVE: To prospectively evaluate the results from a series of patients who underwent surgical treatment for rhizarthrosis using the technique of trapezium resection associated with interposition of yarn from the long abductor tendon of the thumb. METHODS: From May to August 2005, ten patients underwent surgical treatment for rhizarthrosis. Patients with primary osteoarthrosis of the trapezium-metacarpal joint, in stages II, III and IV of the Eaton classification, with persistent pain that was refractory to clinical treatment, were included. For the functional assessment, the visual analogue scale, DASH questionnaire and Buck-Gramcko score were used. For the overall assessment on the patients, strength measurements were made for palm grip, pulp to pulp pinch, lateral pinch, three-point pinch, opposition and radial and palmar abductions. The migration index for the first metacarpal was also determined on radiographs at rest and under stress. RESULTS: The pain relief was considered to be good (p = 0.005), with functional improvements in modules 2 (p = 0.02) and 3 (p = 0.022) of DASH. The Buck-Gramcko score showed one excellent and three very good results. There was an improvement in almost all of the overall assessment and was only non-significant regarding lateral pinch and abduction. For all patients, there was migration of the first metacarpal. CONCLUSION: Trapeziectomy associated with interposition of yarn from the long abductor tendon of the thumb was shown to be a relatively simple and effective technique for pain relief and functional improvement.

OBJETIVO: O objetivo deste estudo consiste em rever os casos submetidos a tratamento cirúrgico por duas técnicas: trapezectomia com ou sem ligamentoplastia e artroplastia com implante. MÉTODOS: Foram avaliadas 52 mãos tratadas cirurgicamente por rizartrose entre 1995 a 2008: 32 trapezectomias com ou sem ligamentoplastia (grupo A) e 20 artroplastias com implante (grupo B). Follow-up médio: grupo A - 72 meses, grupo B - 23 meses. Não houve resultados significativamente diferentes quanto à dor, atividades da vida diária, mobilidade e força. No estudo radiográfico, a altura escafometacarpiana foi mais preservada no grupo B. O tempo médio de recuperação foi de 10 semanas no grupo A e de 4,5 no grupo B. Foram registradas quatro complicações: um caso de algoneurodistrofia no grupo A e 2 casos de luxação e um caso de fratura do trapézio no grupo B. RESULTADOS: O resultado das próteses superam o tratamento tradicional da rizartrose com trapezectomia com ou sem ligamentoplastia pela rápida recuperação que proporcionam. CONCLUSÃO: Contudo, a sua aplicação deve ser criteriosa, pois existe potencial de complicações relacionadas com os implantes.OBJECTIVE: The aim of this study was to review cases that underwent surgical treatment using two techniques: trapeziectomy with or without ligamentoplasty and arthroplasty with implant. METHODS: Fifty-two hands that were surgically treated for rhizarthrosis between 1995 and 2008 were evaluated: 32 cases of trapeziectomy with or without ligamentoplasty (group A) and 20 with implant arthroplasty (group B). The mean follow-up for group A was 72 months and for group B, 23 months. There were no significantly different results with regard to pain, activities of daily living, mobility or strength. In the radiographic evaluation, it was found that the scaphometacarpal height was better preserved in group B. The mean time taken to achieve recovery was 10 weeks in group A and 4.5 in group B. Four cases with complications were recorded: one case of algoneurodystrophy in group A and two cases of dislocation and one case of fracture of the trapezium in group B. RESULTS: The results from prostheses were better than the results from the traditional treatment for rhizarthrosis using trapeziectomy with or without ligamentoplasty because of the rapid recovery that prostheses provide. CONCLUSION: However, prostheses should be applied carefully, because there is a potential for complications relating to the implants.

Alain Robbe-Grillet's La Jalousie can't be read like a "traditional" romance, it means, a romance that underlines feelings, pains, i.e. the psychology of a jealous husband. But jealousy doesn't exist without a triangle. Three persons are necessary for one of them becoming jealous. That's why tihis romance has been built on this geometric figure and on that number. In addition, jealousy stands always in a state of uncertainty. This one can be considered, too, as inherent in writing and reading. That's what this romance puts over the reader's eyes. Reader must then make a work of reading equivalent to the work of writing that the author made uphill.