SURGICAL-MANAGEMENT OF ARTHRITIS OF THE CARPO-METACARPAL JOINT OF THETHUMB

In the years 1970-90, 118 procedures were performed on 100 patients wi th arthritis (osteoarthritis in all but 13) of the carpo-metacarpal jo int of the thumb. The patients were aged 17 to 83 years (mean 54.5 yea rs); 75 were females and 25 males; there were 73 right and 45 left han ds; 18 patients had bilateral procedures. The average follow up period was 4.3 years, with a range of 1 to 20 years. Sixteen of the 118 proc edures were arthrodeses; all these patients had isolated trapezio-meta carpal joint arthritis. Fifteen procedures were trapeziectomies and so ft tissue arthroplasties; they were performed for pan-trapezial arthri tis in the older age group, or as a secondary procedure for failed pre vious operations. Eighty-seven of the 118 procedures were silicone par tial or total arthroplasties either for pan-trapezial arthritis or iso lated trapezio-metacarpal joint arthritis (53 trapezium, 32 metatarso- phalangeal and 2 condyle implants). The overall results were: arthrode sis (68.7% good, 18.8% fair, 12.5% poor); soft tissue arthroplasty (80 % good, 6.7% fair, 13.3% poor); silicone total arthroplasty (73.5% goo d, 15.1% fair, 11.3% poor); silicone hemiarthroplasty (68.8% good, 15. 6% fair, 15.6% poor). No silicone synovitis was found in any of the 87 cases of silicone arthroplasties.