The Rheumatoid Thumb - 22/08/11

Doi : 10.1016/j.hcl.2008.03.005

Aron T. Chacko, BS ^a, Tamara D. Rozental, MD ^b,^⁎
^a Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA
^b Harvard Medical School, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Stoneman 10, Boston, MA 02215, USA

Corresponding author.

Abstract

Rheumatoid arthritis of the thumb is a common source of disability. Obtaining an understanding of the underlying biologic and physical manifestations of rheumatoid arthritis is essential in the choice of treatment of the disease. In the early stages of the disease, conservative and less invasive measures can be used. In the more advanced stages, arthrodesis and arthroplasty are often used. Isolated interphalangeal involvement is best managed with arthrodesis. Metacarpophalangeal involvement in low-demand patients can be treated with arthroplasty, whereas arthrodesis can be used in more active patients. Patients who have carpometacarpal joint damage are best treated with trapezium resection arthroplasty.

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Esquema

Modified with permission. Significant portions of this article are directly reprinted from the following: ©2007 American Academy of Orthopedic Surgeons. Reprinted from the Journal of the American Academy of Orthopedic Surgeons, Volume 15(2). pp.118–125; with permission.