Indications and techniques for thumb carpometacarpal arthrodesis

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Rheumatology

Background:

• Thumb carpometacarpal (CMC) arthritis commonly affects postmenopausal women due to ligamentous attenuation.
• It can also occur in younger men following intraarticular fractures of the first metacarpal base.
• While nonoperative treatments are often effective, surgical options provide alternatives for persistent symptoms.

Purpose of the Study:

• To review the efficacy and outcomes of surgical interventions for thumb CMC arthritis.
• To compare arthroplasty and arthrodesis as surgical treatment options.
• To highlight the reliability and patient satisfaction associated with thumb CMC arthrodesis.

Main Methods:

• Review of current literature on surgical treatments for thumb CMC arthritis.
• Comparison of outcomes between arthroplasty and arthrodesis.
• Description of surgical techniques and potential complications for arthrodesis.

Main Results:

• Thumb CMC arthrodesis demonstrates reliable and durable results, offering excellent strength and range of motion.
• Patient satisfaction rates for arthrodesis are consistently high.
• Arthroplasty is typically reserved for older, low-demand patients, while arthrodesis is favored for younger individuals, though outcomes are increasingly similar.
• Nonunion rates for arthrodesis are approximately 13%, with hardware-related pain as another potential complication.

Conclusions:

• Thumb CMC arthrodesis is a highly effective and durable surgical treatment for thumb CMC arthritis, yielding excellent patient outcomes.
• While arthroplasty and arthrodesis show similar results, arthrodesis provides superior strength and patient satisfaction.
• Contraindications for arthrodesis include concomitant scaphotrapeziotrapezoid joint arthritis.