FUSION OF THE 1ST METACARPOPHALANGEAL JOINT FOR POSTTRAUMATIC CONDITIONS

Fusion of the metarcarpophalangeal joint of the thumb is an accepted t reatment in the management of instability or osteoarthritis following trauma to this joint. A review was made of the literature and 30 of th e senior author's (RH) patients who had had this operation, in order t o determine what effect the operation had on the pain in their thumb, any symptoms of instability, interference with work and daily activiti es, and strength in the hand. All of the patients achieved bony union and the average angle of fusion was 7.6 degrees of flexion. All of the patients were either satisfied or very satisfied with the results of the operation, and had an average increase of 6.3 points on a 12 point rating scale. However, 48% of patients had some mild intermittent pai n and 43% complained of some difficulty with fine motor tasks. Twelve patients were able to attend for formal evaluation including the Jebso n and Crawford Hand Function Tests which revealed some decrease in han d function in all of those tested. It was concluded that this method o f arthrodesis of the metacarpophalangeal joint of the thumb gives reli able results, with high patient acceptance, but does not result in an entirely normal thumb or hand function.