Long-Term Follow-Up of First Metacarpal Extension Osteotomy for Early CMC Arthritis

Abstract

Background

The purpose of this study was to evaluate long-term outcomes of first metacarpal extension osteotomy for early trapeziometacarpal arthritis.

Methods

We retrospectively reviewed 13 patients who underwent first metacarpal extension osteotomy at our institution between 1996 and 2005 and obtained subjective and objective outcome data.

Results

Mean follow-up was 9.9 years (range 6 to 14 years). Ten of the 13 patients (77 %) were either satisfied or very satisfied with their results. Mean pain level was 2.00 on a scale of 1 (nonexistent) to 7 (unbearable). Mean QuickDASH score was 24.17, with a median score of 9.09. Mean pinch strength was 13.1 lbs compared to 12.8 lbs in the nonoperative extremity. Mean radial abduction of the thumb was 45.5° which was equal to the nonoperative extremity. Of the eight patients who agreed to repeat radiographs, five had no progression of degenerative changes compared to pre-op radiographs.

Conclusions

Based on subjective and objective follow-up data, first metacarpal extension osteotomy can provide good long-term results in terms of patient satisfaction, pain relief, and upper extremity function. It is a reasonable alternative to ligament reconstruction in patients with early-stage trapeziometacarpal arthritis.