Clinical Outcomes of Trapeziometacarpal Arthrodesis with a Mean 3-Year Follow-up

Background  This paper's purpose was to analyze clinical results obtained with trapeziometacarpal arthrodesis and complications comparing different osteosynthesis systems. Methods  Thirty-seven trapeziometacarpal arthrodesis were performed in our center in a 7-year period, with a mean age of 52 years and 34 months of follow-up. The implants were distributed homogenously into three groups, using bone grafts in 12.5% of them. Results  A 75% achieved complete consolidation with a mean postsurgical Visual Analog Scale (VAS) of 2.4, Kapandji Opposition Score (KOS) of 8.1, lateral pinch strength of 12.1 kg, tripod pinch strength of 3.6 kg, and tip-to-tip strength of 1.5 kg. Consolidation was not achieved in nine patients, of which five were asymptomatic, three reoperated on trapeziectomy and tenosuspension, and one rearthrodesis. No statistical association was found between the implant used and pseudoarthrosis ( p  = 0.17), VAS ( p  = 0.06), or KOS ( p  = 0.45). Conclusions  Trapeziometacarpal arthrodesis reduces pain for well-chosen patients. Nonunion has low clinical significance in most cases and does not seem to depend on the use of allograft or the type of implant but on an appropriate surgical technique.