Prevalence of osteoarthrosis of the trapeziometacarpal joint.
BACKGROUND
The age and gender-related prevalence of arthrosis of the trapeziometacarpal joint has been incompletely defined.


METHODS
The radiographs of 615 consecutive patients who had presented with an isolated fracture of the distal part of the radius over a two-year period were evaluated for evidence of trapeziometacarpal arthrosis. We used a simple three-grade rating system suitable for standard wrist radiographs. Grade I indicated no or nearly no arthrosis; grade II, obvious arthrosis; and grade III, a totally destroyed joint. This rating system was demonstrated to have adequate intraobserver reliability (average kappa of 0.72, p < 0.001) and interobserver reliability (average kappa of 0.56, p < 0.001). The number of patients with each grade of arthrosis was analyzed according to age and gender.


RESULTS
The overall radiographic prevalence of trapeziometacarpal arthrosis in patients with a distal radial fracture increased steadily from the age of forty-one years onward and reached a prevalence of 91% in patients older than eighty years of age. The prevalence increased more rapidly in women than in men; it reached 94% in women who were older than eighty years of age compared with 85% in men who were older than eighty years of age. The prevalence of grade-III trapeziometacarpal arthrosis (a totally destroyed joint) was much greater in women than in men at all age levels; it reached a prevalence of 66% in women older than eighty years of age compared with 23% in men older than eighty years of age.


CONCLUSIONS
The radiographic prevalence of trapeziometacarpal arthrosis in patients presenting for treatment of a distal radial fracture is age-related, and trapeziometacarpal arthrosis is more likely to lead to complete joint destruction in women than it is in men.
Sodha
Samir
S
Hand and Upper Extremity Surgery, Crystal Run Healthcare, 155 Crystal Run Road, Middletown, NY 10941.
Ring
David
D
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. dring@partners.org.
Zurakowski
David
D
Department of Biostatistics, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115.
Jupiter
Jesse B
JB
Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Yawkey Center, Suite 2100, 55 Fruit Street, Boston, MA 02114. dring@partners.org.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D050279:Metacarpal Bones; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D011885:Radius Fractures / Q000150:complications*; D012737:Sex Factors; D051223:Trapezoid Bone; D014955:Wrist Joint