Arthrodesis of the carpometacarpal joint of the thumb with plate fixation and bone grafting: a retrospective review

Abstract

Background: Arthrodesis of the carpometacarpal (CM) joint of the thumb has been recognized as a common technique that gives pain relief, stability, and strength, but it has some disadvantages, such as nonunion, pantrapezial osteoarthritis, and reduced mobility.

Methods: Thirteen thumbs of 12 patients with CM joint arthritis who underwent CM joint arthrodesis were reviewed retrospectively. The average age of the patients was 61.0 years. The follow-up period ranged from 2 to 5 years. Arthrodesis was performed with a T-plate and an autogenous iliac cancellous bone graft for all patients.

Results: All thumbs had radiographic evidence of union, and there was no nonunion. No reduction of motion of the interphalangeal and metacarpophalangeal joint of the thumb was found after surgery. Postoperatively, scaphotrapeziotrapezoid arthritis and metacarpophalangeal arthritis progressed in two joints each. The Disabilities of the Arm, Shoulder, and Hand score improved from 39.9 (range 8-69) to 11.1 (range 0-23.1). All patients had no or slight problems of the thumb and no complaints related to the pelvis in daily living and were either very satisfied or satisfied with the surgery.

Conclusions: Arthrodesis of the thumb CM joint with a plate and bone graft achieved satisfactory results in all cases with very few complications. This procedure is a valuable tool in middle-aged and elderly patients with thumb CM joint arthritis.