Management of Thumb Metacarpophalangeal Hyperextension in the Setting of Thumb Basal Joint Arthritis.

Abstract

Thumb metacarpophalangeal (MCP) joint hyperextension is a well-established sequela of advanced carpometacarpal (CMC) joint arthritis. This deformity results in poor patient function because the ability to perform key pinch is negatively affected. For this reason, surgeons must consider the presence of an MCP deformity when addressing CMC arthritis. A variety of nonsurgical and surgical interventions have emerged. Surgical treatments can be grouped into four main categories: (1) volar plate advancement/capsulodesis, (2) tendon transfer and tenodesis, (3) sesamoidesis, and (4) arthrodesis. Surgical intervention is based on both the degree of deformity present and the surgeon preference. This review aims to clarify indications for various treatments of MCP joint hyperextension, outline commonly performed procedures, and report the published outcomes and potential complications of these interventions.