Thumb Arthrodesis

Abstract

Arthrodesis of the thumb carpometacarpal, metacarpophalangeal, and interphalangeal joints are well-established options in the management of arthritis, instability, and/or deformity. This review includes a general review of the indications and technique of arthrodesis and recent review of the literature. New literature has focused on the role of arthrodesis in managing carpometacarpal arthritis and compared its results with ligament reconstruction and tendon interposition. However, no conclusive evidence demonstrates the superiority of arthrodesis. Several new articles have demonstrated good long-term results of carpometacarpal arthrodesis. A new report on complications associated with plate and screw fixation for carpometacarpal arthritis has been published, leading the authors to conclude that k-wire fixation was a better option. A technique of metacarpophalangeal joint arthrodesis using a cannulated screw has been recently published with good success. Moreover, a cup-in-cone technique of reaming surfaces of the thumb metacarpophalangeal joint to maximize bone contact surface area has been described. Other authors have reiterated and reinforced the success of some of the more standard techniques including Herbert screws for interphalangeal joint arthrodeses. Thumb arthrodesis of the carpometacarpal, metacarpophalangeal, and interphalangeal joints maintains a significant role in the management of deformity and arthritis. Better comparison studies are necessary in evaluating arthrodesis of the carpometacarpal joint versus arthroplasty. New fixation techniques for metacarpophalangeal joint arthrodesis are promising. Standard fixation for interphalangeal joint fusion has been reiterated. Successful arthrodesis can lead to excellent patient outcomes and function.