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THUMB ARTHRITIS


WHAT YOU SHOULD KNOW

The term arthritis simply refers to the condition of a joint losing its smooth cartilage surface. When this happens the two bones that make up the joint begin to contact each other. This friction and grinding causes pain, swelling, stiffness and further cartilage loss. Osteoarthritis has no special cause other than use of the joint for many years throughout life. Other types of arthritis are special inflammatory conditions such as rheumatoid arthritis or post-traumatic damage to the joint causing arthritis.

MEDICAL HISTORY

The symptoms usually set in slowly over time. Eventually patients complain of lost function, pain, stiffness, swelling, weakness, and sometimes deformity. The doctor will ask questions to determine whether the arthritis is post-traumatic, osteoarthritis, or a special inflammatory arthritis.

EXAMINATION

The joints are tested for range of motion, stability, alignment, and any grinding during movement.

ADDITIONAL TESTS: Plain x-rays show the degree of arthritis and any bone loss or erosion that may have happened.

TREATMENT OPTIONS

 NON-OPERATIVESURGICAL JOINT FUSIONSURGICAL JOINT REPLACEMENT
CONSISTS OFOral arthritis medications, cortisone joint injectionsCausing the 2 bones that make up the joint to become one unitRemoving the smaller bone involved in the grinding and suspending the thumb bone from its neighbor
FEATURESLimited number of injections is allowedUsed for the joints at the tip and the middle of the thumbUsed for the joint at the base of the thumb near the wrist
ADVANTAGESAvoids surgerySolid and durablePreserves motion
DISADVANTAGESOnly treats the symptoms not the underlying bone contactNo motion, small chance of not healing or fusing correctlyLimit on maximum amount of pinch and grip strength, can potentially weaken over time

RECOVERY

Sutures are removed in the office at 2 weeks. Fusions are protected by splints from stress until x-rays prove that healing has occurred. The screws placed in the bones to cause fusion remain in place. The time to healing may be anywhere from 8 to 12 weeks. The rate of failing to fuse in the published literature is around 10%. Following arthroplasty, the thumb and wrist are pinned and immobilized in a cast for 6 weeks. The pin is then removed and outpatient rehabilitation exercises to increase motion and strength are started. The goal is to return the patient to using the hand for all normal activities by 3 months after surgery. Additional increases in strength and function occur gradually over time.
 
 
 
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  • Glad i came to see the wrist center for a second opinion. i feel i am being cared for by the best in the area and i will be able to resume my life. - 01/27/12
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  • I have seen 4 other physicians...for my finger laceration and NONE of them explained my condition, options and the science behind the injury as well as Dr. Mark Henry. - 01/05/11
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