Arthrodesis of small joints, illustrated by the carpometacarpal joint of the thumb

Operative Orthopädie und Traumatologie
Rene K Marti, Johannes Schröder

Abstract

Elimination of pain, impairment of function, and loss of power due to basal joint osteoarthritis of the thumb. Idiopathic or posttraumatic osteoarthritis of the basal joint of the thumb. The technique is equally suitable for arthrodesis of the first tarsometatarsal joint or the first metatarsophalangeal joint following a failed Keller-Brandes operation or failed prosthesis. Total or subtotal resection of the trapezium. Osteoarthritis of the distal scaphoid joint (triscaphoid joint). Technique for a stable fixation of small joints, illustrated by arthrodesis of the carpometacarpal joint of the thumb. A plate is bent distally and used as a washer for a small-fragment compression screw, crossing the former joint space and the inserted bone graft. Additional compression is achieved by asymmetric drilling of the proximal screw (asymmetric insertion principle). Plaster splint for 5 days, then early functional treatment. In a clinical trial, 16 patients with idiopathic basal joint osteoarthritis of the thumb (18 joints) were followed up for an average of 6 years postoperatively. The main objective of the operation, namely, pain relief, was achieved in all cases. Only one case required revision due to nonunion.

Citations

Aug 11, 2017·Operative Orthopädie und Traumatologie·T PillukatJ van Schoonhoven
Apr 4, 2017·The Cochrane Database of Systematic Reviews·Anne WajonLouise Ada

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