During a twelve-year period, twenty-eight patients (thirty thumbs) were
treated for painful idiopathic arthritis of the metacarpotrapezial joint of
the thumb by fusion. Failure of fusion occurred in two thumbs, and in both
instances a solid fusion followed a second procedure. Fusion of the
metacarpotrapezial joint did not predispose to painful arthritis of the
trapezioscaphoid joint, even in patients with pre-existing roentgenographic
evidence of minor degenerative changes in this joint. The results after
long-term follow-up were gratifying, the patients having painless and
stable thumbs with excellent strength. Although patients noted a minor loss
of thumb motion, they did not consider this a problem. Fusion is a
satisfactory procedure for patients who need or desire a strong, painless
thumb, and seems especially worth while in the dominant thumb when both
thumbs require surgical treatment.