title: Results following trapeziometacarpal arthroplasty of the thumb.
abstract: A retrospective follow-up study was performed on patients with degenerative joint disease (DJD) who underwent trapeziometacarpal arthroplasty of the thumb with 3-week immobilization and without the use of K-wire fixation. Pre- and post-operative pain, activities of daily living (ADLs), grip strength, and pinch strength were compared. Data were collected on 25 hands in 23 patients, 7 hands with full trapezium resections and 18 with hemi-trapezium resections. The median age was 60 years, with a range of 39 to 73 years, and the median follow-up period was 1 year 11 months, with a range of 3 months to 11 years. Grip and pinch strength were measured pre- and postoperatively. Pain was assessed on a visual analog scale (VAS), and ADLs were assessed by means of a 15-item survey. Both pain and ADLs were evaluated postoperatively with recall of preoperative status. Following surgery, all thumbs were immobilized in a static splint for 3 weeks and then allowed progressive use. Median improvements in hemi-trapezium resections included grip, 22.5 lb; pinch, 4.7 lb; and ADLs, 33%. Pain was reduced a median of 7.0 cm on the VAS. Median improvements in full trapezium resection included grip, 29.5 lb; pinch, 0 lb; ADLs, 60%; and pain reduction, 8 cm on the VAS. This follow-up study suggests that satisfactory results can be achieved in pain reduction, strength, and ADLs with an immobilization period of only 3 weeks and without the use of K-wires following carpometacarpal (CMC) arthroplasty.
authors.affiliation: Hand Management Center, St. Dominic Hospital, Jackson, Mississippi 39216, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Roberts
authors.forename: M E
authors.initials: ME
authors.lastname: Jabaley
authors.forename: T G
authors.initials: TG
authors.lastname: Nick
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001178:Arthroplasty / Q000379:methods* / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008663:Metacarpus; D008875:Middle Aged; D010003:Osteoarthritis / Q000503:physiopathology / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013709:Tendon Transfer; D013710:Tendons / Q000503:physiopathology / Q000601:surgery; D013933:Thumb / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome