Arthrodesis for treatment of first carpometacarpal joint arthritis: a preliminary report

Objective To evaluate the clinical efficacy of arthrodesis for treatment of first carpometacarpal joint arthritis. Methods From August 2010 to January 2015, 29 patients underwent arthrodesis of the first carpometacarpal joint for arthritis of the thumb. There were 5 males and 24 females with an average age of 58 years (range, 45 to 71 years). The left side was involved in 9 thumbs and right side in 20 thumbs. According to Eaton-Glickel classification, 4 thumbs belonged to stage Ⅱ, and 25 thumbs to stage Ⅲ. Joint fusion was achieved by micro-plate fixation in all the cases, while 6 patients had autologous bone graft from the distal radius as well. Pain level (visual analogue scale, VAS), grip strength, tip pinch strength and range of motion were recorded. The post-operative X-ray and peri-trapezium arthritis were observed. The results were statistically analyzed. Results All patients were follow-up for 6 months to 4 years, with an average of 25.2 months. Joint fusion rate was 100%. Grip strength and tip pinch strength improved after the surgery. VAS was significantly reduced. The differences were statistically significant. There were 4 cases of postoperative osteoarthritis mostly around the corner of the trapezium, but patient satisfaction was high. The mean VAS was 0.7 when moving thumbs. Conclusion Arthrodesis is an effective method for the treatment of first carpometacarpal joint arthritis. It is also indicated in isolated first carpometacarpal arthritis in elderly patients. Despite arthritis around the trapezium, patient satisfaction is high, without the need for further treatment. Key words: Thumb; Carpometacarpal joints; Osteoarthritis; Arthrodesis