Outcomes of Arthrodesis for Thumb Carpometacarpal Joint Osteoarthritis Using a Headless Compression Screw and Locking Plate With Autologous Bone Grafting: A 1-Year Follow-up Study

Abstract

Background:

Thumb carpometacarpal (CMC) joint osteoarthritis is a common degenerative condition that causes pain and dysfunction, particularly in middle-aged and elderly individuals. Arthrodesis offers reliable pain relief and joint stability but is associated with a risk of pseudarthrosis depending on the fixation method. This study aimed to evaluate the clinical outcomes of thumb CMC arthrodesis using a headless compression screw (HCS) and locking plate with autologous bone grafting.

Methods:

This retrospective case series included 17 patients (17 hands) who underwent thumb CMC arthrodesis between 2020 and 2022. The procedure involved curettage of the joint surface, bone grafting, fixation with an HCS, and dorsal locking plate. Postoperative outcomes were assessed using bone union rate, time to union, visual analog scale (VAS) for pain, Disabilities of the Arm, Shoulder, and Hand (DASH) score, Kapandji score, grip strength, and pinch strength. All parameters were evaluated preoperatively and at 1-year follow-up.

Results:

All patients achieved radiographic union (100%) with a mean time to union of 10.5 weeks. Median VAS improved from 70 to 6, and DASH score improved from 39.8 to 11.2. Kapandji score remained unchanged. Grip strength showed mixed results, with a median decrease but mean increase. Lateral-pinch and tip-pinch strengths improved significantly. No major complications such as pseudarthrosis or hardware failure were observed.

Conclusion:

Thumb CMC arthrodesis using HCS, locking plate, and autologous bone grafting results in high union rates and substantial pain relief, offering a reliable technique particularly suited for patients with compromised bone quality.