RESEARCH ARTICLE


Metacarpophalangeal Joint Arthrodesis of the Thumb – Minimum of Eight Months Follow-up



Rasmus Wejnold Jørgensen*, 1, Stig Brorson2, Claus Hjorth Jensen1
1 Orthopedic Department, Gentofte Hospital, 2900 Hellerup, Denmark
2 Orthopedic Department, Herlev Hospital, 2730 Herlev, Denmark


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© Jørgensen et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (https://creativecommons.org/licenses/by-nc/4.0/legalcode), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Orthopedics, Gentofte Hospital, Kildegaardsvej 78, 2900 Hellerup, Denmark; Tel: +45 40251150; E-mail: pzg345@alumni.ku.dk


Abstract

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 outcome of this treatment.

Purpose:

The purpose of this study was to report outcome and disability following thumb MCP joint arthrodesis in the treatment of chronic instability after traumatic injuries.

Methods:

A retrospective review of 26 patients operated on with MCP joint arthrodesis, median follow-up 42 months (8-104months). Subjective outcome was 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 stating whether they would undergo the same procedure again.

Results:

Two patients (7.7%) needed re-operation due to nonunion. 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 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.

Conclusion:

Our data suggest, that patients with post-traumatic thumb injuries 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 disability scale by the National Board of Industrial Injuries should be reconsidered for patients operated on with thumb MCP arthrodesis.

Keywords: Metacarpophalangeal joint, Arthrodesis, Thumb, Patient reported outcome, Follow-up, DASH score.