Long-term outcomes of first metacarpal extension osteotomy in the treatment of carpal-metacarpal osteoarthritis.

Abstract

The purpose of this study was to investigate the long-term outcomes of first metacarpal extension osteotomy in the treatment of osteoarthritis of the thumb carpal-metacarpal joint. We retrospectively reviewed 8 patients treated by a single surgeon with first metacarpal extension osteotomy. Preoperative Eaton stage was I in 3 patients, II in 3 patients, and III in 2 patients. Mean follow-up was 9 years (range, 6-13 years). Average lateral pinch strength, oppositional pinch strength, and grip strength were measured as 5 kg, 3 kg, and 19 kg, respectively (129%, 103%, and 108% of contralateral). Eaton stage was preserved in 5 of the 8 patients, with excellent functional outcomes in 6 of 8 patients at a mean of 9 years. Our data suggest that first metacarpal extension osteotomy can be an effective and durable procedure that does not limit future salvage procedures such as trapeziectomy or arthroplasty and support use of this treatment in early and moderate Eaton stages. Therapeutic IV.