title: Thumb Reconstruction with Arthrodesis to the Second Metacarpal following Sarcoma Excision.
abstract: Primary sarcomas of the thumb metacarpal are rare malignant lesions. Surgical treatment involves amputation versus tumor resection with thumb reconstruction. If complete tumor resection is possible, thumb preservation may be considered, as the thumb is vital to hand function. Following tumor resection, previous reports have described graft reconstruction with fusion to the trapezium or scaphoid. We present two cases of sarcoma necessitating resection of the thumb metacarpal that were reconstructed with an arthrodesis of the proximal phalanx to the second metacarpal shaft. Arthrodesis to the second metacarpal allows robust bony contact for fusion as well as improved resting position of the thumb. At 2- and 4-year follow-up, both patients have a stable, pain-free thumb without evidence of local recurrence.
authors.affiliation: Department of Orthopaedic Surgery, Loma Linda University Medical Center, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Hein
authors.affiliation: Department of Orthopaedic Surgery, Loma Linda University Medical Center, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA.
authors.forename: Barry
authors.initials: B
authors.lastname: Watkins
authors.affiliation: Department of Orthopaedic Surgery, Loma Linda University Medical Center, 11406 Loma Linda Drive, Suite 218, Loma Linda, CA 92354, USA.
authors.forename: Lee M
authors.identifier: 0000-0001-7762-2906
authors.initials: LM
authors.lastname: Zuckerman