Arthrodesis of small joints, illustrated by the carpometacarpal joint of the thumb.
OBJECTIVE
Elimination of pain, impairment of function, and loss of power due to basal joint osteoarthritis of the thumb.


METHODS
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.


METHODS
Total or subtotal resection of the trapezium. Osteoarthritis of the distal scaphoid joint (triscaphoid joint).


METHODS
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).


METHODS
Plaster splint for 5 days, then early functional treatment.


RESULTS
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.
Orthopädisch-Traumatologische Universitätsklinik, Akademisches Medizinisches Zentrum der Universität Amsterdam, Niederlande.
Rene K
RK
Marti
Johannes
J
Schröder
D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation; D001863:Bone Screws; D016025:Bone Transplantation; D005500:Follow-Up Studies; D006801:Humans; D008662:Metacarpophalangeal Joint / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D013933:Thumb / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome