Carpometacarpal Arthrodesis

Basal thumb arthritis surgery: complications and its management

“…Fusion of the thumb CMC joint is a treatment option for painful and progressively destructive OA, which is often reserved for younger patients with high demands on grip strength (London and Stern, 2022). In a randomized controlled study, resection arthroplasty clearly outperformed the joint fusion procedure in treating the classical indication of OA in women aged 40 years and older (van Laarhoven et al., 2019).…”

How does Fixation Alignment Affect Surgical Outcomes in Arthrodesis for Thumb Carpometacarpal Osteoarthritis?

“…Several surgical procedures are used for treating thumb carpometacarpal (CMC) osteoarthritis, including simple trapeziectomy, trapeziectomy and ligament reconstruction with tendon interposition (LRTI), trapeziectomy with suture suspension, abduction osteotomy, prosthetic replacement, and arthrodesis. 1 2 3 4 5 6 7 8 9 10 In recent surveys, the frequency of arthrodesis has been found to be low at 0.6 to 7.5% in the United States and Europe 11 12 13 ; nevertheless, it is still a useful method for providing hand strength and pain relief. 4 14 In many studies, the thumb CMC joints have been fixed in the position described by Leach and Bolton, 15 such as “the distal phalanx of the thumb rests on the middle phalanx of the index finger in a fully clenched fist.” 16 17 18 19 20 21 This position is widely accepted; however, the exact alignment, including palmar abduction, radial abduction, and rotation of the first metacarpal, has not been specified.…”

“…1 2 3 4 5 6 7 8 9 10 In recent surveys, the frequency of arthrodesis has been found to be low at 0.6 to 7.5% in the United States and Europe 11 12 13 ; nevertheless, it is still a useful method for providing hand strength and pain relief. 4 14 In many studies, the thumb CMC joints have been fixed in the position described by Leach and Bolton, 15 such as “the distal phalanx of the thumb rests on the middle phalanx of the index finger in a fully clenched fist.” 16 17 18 19 20 21 This position is widely accepted; however, the exact alignment, including palmar abduction, radial abduction, and rotation of the first metacarpal, has not been specified. Indeed, previous studies have investigated surgical outcomes with a focus on the fixation technique, bone union rate, and surgical complications such as hardware irritation and adjacent joint degeneration, but not on the postoperative alignment of the thumb CMC joints.…”

First Dorsal Metacarpal Artery-pedicled Second Metacarpal Vascularized Bone Graft for Nonunion after Thumb Carpometacarpal Arthrodesis

“…Postoperative nonunion associated with thumb CMC arthrodesis is sometimes asymptomatic and does not necessarily require revision surgery 5 ; however, symptomatic cases require additional surgery, including trapezial resection arthroplasty, with or without tendon interposition and revision arthrodesis. 6 Considering that arthrodesis is mainly used for young patients and manual workers who wish to obtain stable and painless thumbs, 1,2 revision arthrodesis could be the first choice for revision surgery. However, revision arthrodesis and its outcomes for this pathological condition have not been well documented.…”

“…rthrodesis is a reliable surgical procedure for treating thumb carpometacarpal (CMC) osteoarthritis because it provides strong grip strength, pinch strength, and pain relief. 1 The most frequent and problematic complication of arthrodesis is nonunion, with a frequency of up to 39%. [2][3][4] Despite recent improvements in fixation materials and surgical methods, nonunion still occurs.…”