Rene K Marti1, Johannes Schröder. 1. Orthopädisch-Traumatologische Universitätsklinik, Akademisches Medizinisches Zentrum der Universität Amsterdam, Niederlande.
Abstract
OBJECTIVE: Elimination of pain, impairment of function, and loss of power due to basal joint osteoarthritis of the thumb. INDICATIONS: 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. CONTRAINDICATIONS: Total or subtotal resection of the trapezium. Osteoarthritis of the distal scaphoid joint (triscaphoid joint). SURGICAL TECHNIQUE: 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). POSTOPERATIVE MANAGEMENT: 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.
OBJECTIVE: Elimination of pain, impairment of function, and loss of power due to basal joint osteoarthritis of the thumb. INDICATIONS: 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. CONTRAINDICATIONS: Total or subtotal resection of the trapezium. Osteoarthritis of the distal scaphoid joint (triscaphoid joint). SURGICAL TECHNIQUE: 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). POSTOPERATIVE MANAGEMENT: 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.