title: Palmar plate capsulodesis for thumb metacarpophalangeal joint hyperextension in association with trapeziometacarpal osteoarthritis.
abstract: Hyperextension of the thumb metacarpophalangeal (MCP) joint is frequently seen with trapeziometacarpal osteoarthritis, but there is no consensus on the indication for, or type of, treatment. We re-examined 12 thumbs at a mean of 9 (range 6-13) years following MCP capsulodesis using a suture anchor performed with trapeziectomy. Mean MCP hyperextension improved from 45° pre-operatively to 19° at 1 year post-operatively. At 9 years follow-up, it had increased to 30° but was still significantly better than pre-operatively (p = 0.007). Mean MCP flexion was 37° and near normal opposition was retained. The median pain score had improved from 5.5 to 1 (p = 0.002). Thumb key and tip pinch and hand grip strength showed no significant change from pre-operative values. No thumb MCP had symptomatic radiological degeneration. Our results suggest that MCP capsulodesis preserves a useful range of MCP flexion but stretches out over time. However, this did not result in increased pain or thumb weakness.
authors.affiliation: Departments of Trauma and Orthopaedic Surgery, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK.
authors.forename: N J K
authors.initials: NJ
authors.lastname: Miller
authors.forename: T R C
authors.initials: TR
authors.lastname: Davis
mesh_terms: D000368:Aged; D001174:Arthrodesis; D005260:Female; D005383:Finger Injuries / Q000150:complications; D006801:Humans; D017746:Joint Capsule / Q000601:surgery*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries / Q000601:surgery*; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications*; D053401:Palmar Plate / Q000601:surgery*; D013933:Thumb / Q000601:surgery*; D051222:Trapezium Bone / Q000601:surgery
keywords: Capsulodesis; MCP joint; thumb; trapeziectomy