Fixation method does not influence functional outcomes after thumb metacarpophalangeal arthrodesis

Thumb metacarpophalangeal arthrodesis may be done by a variety of techniques. This study examines range of motion, complications and patient-reported outcomes after arthrodesis using different fixations.

Patients treated at a single institution from 2013 to 2025 were retrospectively identified. The fixation techniques were categorized as plate, screw, Kirschner wires with tension band or Kirschner wires alone. Indications included degenerative osteoarthritis and post-traumatic instability; patients with inflammatory arthritis were excluded. Outcomes included range of motion, visual analogue scale pain scores, Patient-Reported Outcome Measurement Information System scores and complications. A secondary cohort treated by arthrodesis alone excluded patients with concurrent procedures.

A total of 106 patients were included (49 plate, 21 screw, 24 Kirschner wire with tension band and 12 Kirschner wire only). Range of motion, postoperative Patient-Reported Outcome Measurement Information System scores and pain scores were statistically similar for all fixation techniques. Complication rates were similar for all techniques except for removal of fixation, which was most frequent in patients treated by Kirschner wire and tension band (27%). This was also found in the pure arthrodesis cohort. Nonunion rates were low and did not differ by fixation technique.

Thumb metacarpophalangeal arthrodesis has similar functional and patient-reported outcomes in different fixation techniques. However, Kirschner wire fixation with tension bands is associated with a higher instance of fixation removal.

III.