Background: The age and gender-related prevalence of arthrosis of
the trapeziometacarpal joint has been incompletely defined.
Methods: The radiographs of 615 consecutive patients who had
presented with an isolated fracture of the distal part of the radius over a
two-year period were evaluated for evidence of trapeziometacarpal arthrosis.
We used a simple three-grade rating system suitable for standard wrist
radiographs. Grade I indicated no or nearly no arthrosis; grade II, obvious
arthrosis; and grade III, a totally destroyed joint. This rating system was
demonstrated to have adequate intraobserver reliability (average kappa of
0.72, p < 0.001) and interobserver reliability (average kappa of 0.56, p
< 0.001). The number of patients with each grade of arthrosis was analyzed
according to age and gender.
Results: The overall radiographic prevalence of trapeziometacarpal
arthrosis in patients with a distal radial fracture increased steadily from
the age of forty-one years onward and reached a prevalence of 91% in patients
older than eighty years of age. The prevalence increased more rapidly in women
than in men; it reached 94% in women who were older than eighty years of age
compared with 85% in men who were older than eighty years of age. The
prevalence of grade-III trapeziometacarpal arthrosis (a totally destroyed
joint) was much greater in women than in men at all age levels; it reached a
prevalence of 66% in women older than eighty years of age compared with 23% in
men older than eighty years of age.
Conclusions: The radiographic prevalence of trapeziometacarpal
arthrosis in patients presenting for treatment of a distal radial fracture is
age-related, and trapeziometacarpal arthrosis is more likely to lead to
complete joint destruction in women than it is in men.