title: Complications of trapeziometacarpal arthrodesis using plate and screw fixation.
abstract: OBJECTIVE
  This study was designed to determine the complications associated with plate and screw fixation of thumb trapeziometacarpal arthrodesis and to compare these results with a previous report from our institution using K-wire fixation.
  
  
  METHODS
  We retrospectively reviewed 26 trapeziometacarpal arthrodeses that used plate and screw fixation. The most common diagnosis was primary osteoarthritis and the average follow-up evaluation was 40 months. Nineteen patients were available for a clinical follow-up examination and radiographs. These results were compared with the previously published K-wire fixation group that consisted of 59 arthrodeses with an average follow-up period of 84 months.
  
  
  RESULTS
  There were 2 (8%) painful nonunions. There were 6 (23%) hardware malpositions, most frequently associated with a screw in the trapeziotrapezoid joint. Seven (27%) arthrodeses had a second procedure, most commonly hardware removal. Twenty-one (81%) of the patients were satisfied and reported they would have arthrodesis again. In the K-wire fixation group 4 of 59 (7%) arthrodeses went on to nonunion and 2 of 59 required a secondary procedure; patient satisfaction was high (98%).
  
  
  CONCLUSIONS
  K-wire and plate and screw fixation have comparable union rates. In the plate and screw fixation group, however, the satisfaction rate was lower and a second surgery was more common. We now recommend pin fixation when performing trapeziometacarpal joint arthrodesis.
authors.affiliation: Metropolitan Hand Surgery Associates, St. Paul, MN, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Forseth
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Stern
mesh_terms: D001174:Arthrodesis / Q000379:methods*; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D013933:Thumb / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome