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DOS Kongressen 2016 ·
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Metacarpophalangeal joint arthrodesis of the
thumb – a minimum of eight months follow up
Rasmus Wejnold Jørgensen, Stig Brorson, Claus Hjorth Jensen
Ortopædkirurgisk afdeling, Gentofte Hospital; Ortopædkirurgisk afdeling,
Herlev Hospital; Ortopædkirurgisk afdeling, Gentofte Hospital
Background:
Disorders of the thumb metacarpophalangeal (MCP) joint can
lead to significant loss of function, and pain. Thumb MCP arthrodesis following
traumatic injuries is inadequately described and recent studies have questioned
the results follow this treatment.
Purpose / Aim of Study:
The purpose of this study was to report outcome
and disability following thumb metacarpophalangeal (MCP) joint arthrodesis
due to traumatic injuries with chronic instability and pain.
Materials and Methods:
A retrospective review of 26 patients operated
with MCP joint arthrodesis, median follow-up 42 months (8- 104months).
Subjective outcomes were assessed using the Disabilities of the Arm, Shoulder,
and Hand- questionnaire (DASH). In addition, patient satisfaction, pain, stiffness,
and impairment of activities of daily living were assessed on a Visual Analogue
Scale (VAS) followed by a question on whether they would have undergone the
same procedure again.
Findings / Results:
Two patients (7.7%) needed re- operation due to con-
tinuous instability and pain. Four patients (15.4%) needed hardware removal.
Median DASH-score was 18 (25-75% range 6- 47), with lower DASH scores
being better. Scores were significantly worse than in gender and age matched
individuals (p<0.05). Median VAS for pain was 3.7 (range 0-8). More than 50%
of patients reported mild, moderate or severe pain but all patients reported that
they were willing to undergo the same procedure again.
Conclusions:
Our data suggests that patients with post-traumatic thumb in-
juries managed with thumb MCP joint arthrodesis perform worse than gender
and age matched individuals. Many lived with pain, but all reported that they
were willing to undergo the same procedure again. We suggest that the disabil-
ity scale by the National Board of Industrial Injuries should be reconsidered for
patients operated with thumb MCP artrhodesis.
No conflicts of interest reported
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