Fixation method does not influence functional outcomes after thumb metacarpophalangeal arthrodesis

Area of Science:

• Orthopedic surgery
• Hand surgery
• Surgical techniques

Background:

• Thumb metacarpophalangeal (MCP) arthrodesis is a surgical procedure to fuse the thumb's basal joint.
• Various fixation methods exist, including plates, screws, and Kirschner wires (K-wires) with or without tension bands.
• This study compares functional outcomes and complications across different fixation techniques for thumb MCP arthrodesis.

Purpose of the Study:

• To evaluate and compare range of motion, complications, and patient-reported outcomes (PROs) after thumb MCP arthrodesis using distinct fixation methods.
• To identify if specific fixation techniques are associated with better or worse functional results and complication rates.

Main Methods:

• Retrospective review of 106 patients undergoing thumb MCP arthrodesis at a single institution (2013-2025).
• Fixation techniques analyzed: plate, screw, K-wires with tension band, and K-wires alone.
• Outcomes measured: range of motion, Visual Analogue Scale (VAS) pain, Patient-Reported Outcome Measurement Information System (PROMIS) scores, and complications.

Main Results:

• No statistically significant differences in range of motion, PROMIS scores, or VAS pain scores were observed among the fixation groups.
• Complication rates were comparable across techniques, with the exception of hardware removal, which was highest (27%) in the K-wire with tension band group.
• Nonunion rates were low and did not vary significantly based on the fixation method used.

Conclusions:

• Thumb MCP arthrodesis yields similar functional and patient-reported outcomes regardless of the fixation technique employed.
• Kirschner wire fixation with tension bands is associated with a higher incidence of hardware removal compared to other methods.
• The choice of fixation may influence the need for subsequent hardware removal, though overall fusion success and function remain comparable.