Forty-four thumbs in thirty-four patients with rheumatoid arthritis were
treated with a flexible implant arthroplasty of the metacarpophalangeal
joint. After follow-ups ranging from two to six and a half years the
results were rated good to excellent in forty-two thumbs since they were
not painful, had an increased arc of motion of the metacarpophalangeal
joint in a more functional range, and were more effective in the activities
of daily living. The results in this series indicated that careful
reconstruction of the extensor apparatus is essential, as well as
stabilization of the interphalangeal joint either by arthrodesis or by
tenodesis if there is a hyperextension deformity. Of the six patients who
had a fusion of the metacarpophalangeal joint in one thumb and an
arthroplasty in the other, five preferred the arthroplasty because the
joint was stable and also had a useful arc of motion, while one noted no
difference between the two thumbs.