title: Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation.
abstract: We reviewed 63 trapeziometacarpal arthrodeses (57 patients) performed in our unit between April 2007 and May 2013 for osteoarthritis. K-wires, plates, headless compression screws and memory staples were used for fixation. The average age of patients was 50 (range 20-78) years and there were 36 men and 21 women with a mean follow-up of 36 (range 6-62) months. K-wires were used in 31 cases, staples in 12, plates in five, and screws in 15 joints. The overall non-union rate was 11%, however, when using K-wires for fixation, it was 20%. Union was achieved in all cases when staples or screws were used for fixation. Disabilities of the Arm, Shoulder and Hand scores were higher in cases where non-union occurred compared with those that united (66.7 vs. 21.9). Trapeziometacarpal arthrodesis for osteoarthritis gives good clinical outcome with lower (DASH) scores when union occurs. K-wire fixation led to a 20% non-union rate, and as a result, the senior author no longer uses this method of fixation.
authors.affiliation: Wrightington Wigan and Leigh NHW Trust, Wigan and Leigh NHS Trust, UK hpsinghjk@gmail.com.
authors.forename: H P
authors.initials: HP
authors.lastname: Singh
authors.affiliation: Wrightington Wigan and Leigh NHW Trust, Wigan and Leigh NHS Trust, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hoare
authors.affiliation: Wrightington Wigan and Leigh NHW Trust, Wigan and Leigh NHS Trust, UK.
authors.forename: N
authors.initials: N
authors.lastname: Beresford-Cleary
authors.affiliation: Wrightington Wigan and Leigh NHW Trust, Wigan and Leigh NHS Trust, UK.
authors.forename: R
authors.initials: R
authors.lastname: Anakwe
authors.affiliation: Wrightington Wigan and Leigh NHW Trust, Wigan and Leigh NHS Trust, UK.
authors.forename: M
authors.initials: M
authors.lastname: Hayton
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects*; D001864:Bone Wires; D052737:Carpometacarpal Joints / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D005599:Fractures, Ununited / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D012189:Retrospective Studies; D013933:Thumb / Q000601:surgery; D051222:Trapezium Bone / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: Arthrodesis; K-wire; internal fixation; trapeziometacarpal