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.
Keywords: Carpometacarpal arthritis; Metacarpal osteotomy.