Trapeziometacarpal joint arthrodesis: a functional evaluation.
Over a 10-year period, 39 trapeziometacarpal (TM) joint fusions were performed in 37 patients. Pin fixation was used in 27 fusions and staple fixation in 12; all were bone grafted. There were five delayed unions (greater than 3 months) and three nonunions. Twenty-four fusions were evaluated at an average of 4 years. Subjectively, there were 11 excellent, 7 good, 5 fair, and 1 poor result. Grip and pinch strength were symmetrical, and the nine-hole peg test (a measurement of dexterity) was slightly better on the treated side. X-ray films were taken and compared with 25 normal films to assess metacarpal mobility. There was a 72% reduction in the adduction/abduction arc and a 61% reduction in the flexion/extension arc. Despite the marked decrease in motion, subjective functional complaints were minimal. X-ray films were evaluated independently by a radiologist to assess progression of degenerative changes. Only two patients were noted to have changes at the scaphotrapezial joint.
Bamberger
H B
HB
Stern
P J
PJ
Kiefhaber
T R
TR
McDonough
J J
JJ
Cantor
R M
RM
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods; D005260:Female; D005384:Finger Joint / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D013933:Thumb / Q000601:surgery*; D016896:Treatment Outcome