Arthrodesis for the Trapeziometacarpal Arthritis

Lee,  Jong Ha; Yoon,  Jun O; Kim,  Tae Han; Shin,  Yoon Chang

Journal of the Korean Society for Surgery of the Hand 2010;15(2):53-58.
Published online June 1, 2010.

Jong Ha Lee, Jun O Yoon, Tae Han Kim, Yoon Chang Shin

¹Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. joonoyoon@amc.seoul.kr
²Goodmorning Hospital, Pyeongtaek-si, Gyeonggi-do, Korea.

Abstract

Purpose
We evaluated clinical outcomes of the trapeziometacarpal arthrodesis as a treatment for trapeziom-etacarpal arthritis. MATERIALS AND METHODS: Nineteen patients that received trapeziometacarpal arthrodesis for Eaton & Litter stage III(n=18) and IV(n=1) arthritis were enrolled in this study. Mean age was 45.8(43~67) and mean follow up duration was 2.3 years(1~4 years). Posttraumatic arthritis and idiopathic arthritis were 9 and 10 cases, respectively. The assessment included a preoperative and postoperative Visual Analogue Scales (VAS) (0~10) and overall satisfaction with Roles & Maudsley score. Functional outcomes were assessed by measuring of grip and pinch strength and range of thumb motion. The evaluation also included postoperative complications.

Results
Mean preoperative VAS score was 6.6 points and improved to average 1.4 points postoperatively. Mean grip and pinch strength was improved from 12.1 kg to 26.5 kg and from 2.7 kg to 5.2 kg, respectively. The mean radial abduction arc of motion was 42.9 degrees. Metacarpophalangeal and thumb interphalangeal joint arc of motion was averaged 63.3 degrees and 73 degrees, respectively. Complications consisted of scaphotrapezoidal arthritis(n=1) and nonunion(n=1).

Conclusion
The trapeziometacarpal arthrodesis could afford good functional results, pain relief in advanced arthritis patient.