[Arthritis of the thumb (rhizarthrosis) in the elderly]

Osteoarthritis of the base of the thumb is a common and painful condition, mostly observed in post menopausal women. This paper proposes a critical review of the recent papers in the point of view of geriatric medicine. The basal joint of the thumb is formed by the trapeziometacarpal joint and the carpometacarpal joint of the thumb. The trapeziometacarpal joint is a saddle joint with a wide mobility. The trapezium is most important bone which authorizes movement of rotation towards every finger of the hand. Carpometacarpal allows the strength of the hand. Antalgesic drugs are the first treatments. NSAIDs can be applied and reduced pain. Resting hand splint have a significant pain relief, without any side effects. This advantage is appropriate to treatment in elderly subjects. Flexible orthosis is adapted to maintaining activities of daily living in moderate pain. Chirurgical ligament reconstruction tendon interposition is the most common technics used. In elderly subject, trapeziectomy achieved pain relief and adapted to frail elderly.