Journal Contents   |    
View Disclosures and Other Information
From Blodgett Memorial Hospital, Grand Rapids
1972 by The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 1972 Apr 01;54(3):456-471
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


Arthritic involvement of the joints at the base of the thumb can seriously interfere with normal function of the hand. This disability may result from osteoarthritis, traumatic arthritis, or rheumatoid arthritis. The severity of the symptoms and deformity depend on the severity of the destructive changes which occur at the basal thumb joints and the resulting imbalance of forces on the distal thumb joints. The swan-neck deformity seen in rheumatoid thumbs and in severe osteoarthritic thumbs is caused by arthritic changes of the basal joints.

[See figure in the PDF file].

A study of the roentgenograms of the patients selected for reconstructive surgery of the thumb demonstrated that the arthritic changes most frequently occur at the trapeziometacarpal joint, but that the trapezioscaphoid, trapeziotrapezoid, and the trapezio-second metacarpal joints are also involved in a significant number of cases. The trapezium was at the center of the arthritic process in all cases of osteoarthritis and of traumatic arthritis. Rheumatoid patients may have a similar localized involvement of the basal thumb joints. They also may have severe absorptive changes of the trapezium and base of the metacarpal which produces a result not unlike a resection arthroplasty. If the joint is reasonably stable, mobile and pain-free, no surgery is indicated.

A new method of trapezium resection and implant arthroplasty for the treatment of disabilities at the base of the thumb is described. Total resection of the affected trapezium and replacement with a heat-molded, intramedullary-stemmed silicone rubber implant has been used successfully in my clinic for the last five and one-half years. It has restored a stable, mobile, pain-free and powerful thumb. With a mobile joint at the base of the thumb, a severe collapse deformity can be treated by fusion of the distal joints, if need be, without producing a rigid thumb. The indications and surgical techniques are discussed as well as the treatment of the associated collapse deformities of the thumb and the technical pitfalls that must be avoided. The results obtained in forty-six thumbs operated on during the past five and one-half years are presented.

The trapezium resection implant arthroplasty is a reliable method of treatment for disabling arthritis at the base of the thumb if certain simple points of technique are followed.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    Massachusetts - Boston University Orthopedic Surgical Associates
    IL - The University of Chicago's Department of Orthopaedic Surgery and Rehabilitation Medicine