J Korean Orthop Assoc.  2015 Dec;50(6):520-526. 10.4055/jkoa.2015.50.6.520.

Metacarpal Extension Osteotomy for Mild Thumb Carpometacarpal Arthritis: Retrospective Long-Term Outcomes

Affiliations
  • 1Madison Hospital, Cheonan, Korea.
  • 2Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea. csm9827@hanmail.net

Abstract

PURPOSE
We report clinical and radiologic outcomes after metacarpal extension osteotomy for mild osteoarthritis of the thumb carpometacarpal joint.
MATERIALS AND METHODS
From 1999 to 2008, 11 patients were diagnosed with mild thumb carpometacarpal arthritis (Eaton stage I, II), and extension osteotomies were performed. Of these, seven patients with at least 6 years follow-up were analyzed retrospectively. Male to female ratio was 2:5, and mean age at time of surgery was 38.9 years old. Symptom onset period was a mean of 11.2 months. Two patients were I, and five patients were II in Eaton stage. Preoperative visual analogue scale (VAS) and disabilities of the arm, shoulder and hand scale (DASH) scores were 3.7 points (3-4 points), and 40.1 points (32-51 points). Radial abduction was 38.5degrees (30degrees-45degrees), and volar abduction was 42.1degrees (40degrees-45degrees). Grip strengths and pinch powers, compared with the normal contralateral side were 82% (64%-90%) and 72% (40%-100%), respectively.
RESULTS
The mean follow-up period was 8.5 years, and all patients except one maintained their occupational activity during the follow-up period. Final VAS and DASH scores were 0.7 points (0-2 points) and 11.7 points (8-16 points), respectively, and were statistically significant. Volar abduction, grip strengths, and pinch power were improved to 45degrees (40degrees-50degrees), 92.3% (73%-117%), and 94.4% (75%-117%) with statistical significances. In five patients, Eaton stages did not change, and two patients advanced to the next stage (stage I to II in one patient, stage II to III in one patient).
CONCLUSION
Among the various treatment options for mild thumb carpometacarpal arthritis, metacarpal extension osteotomy may be considered as an effective treatment.

Keyword

thumb; carpometacarpal joints; osteotomy

MeSH Terms

Arm
Arthritis*
Carpometacarpal Joints
Female
Follow-Up Studies
Hand
Hand Strength
Humans
Male
Osteoarthritis
Osteotomy*
Retrospective Studies*
Shoulder
Thumb*
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