Basal Joint Arthritis
Arthritis at the base of the thumb or Basal Joint Arthritis is a common
condition that is often overlooked. Patients will complain of pain
at the wrist and base of the thumb. Pain is present with writing and
activities that require a pinch type grip such as turning a key in
a door or or opening a can. Women are more often affected then men.
Non operative treatment consists of modifications of activities of
daily living and use of a splint that protects the base of the thumb.
Writing with a pen that has a wide grip relieves the pain caused by
writing. It may also be helpful to put a large head on commonly used
keys as this will decrease stresses. Supermarkets often sell rubber
grips that help opening jars.
When these measures are insufficient in relieving pain, surgery may
be considered. If x-rays show minimal joint arthritis, it may be possible
to reconstruct a ligament that stabilizes the basal joint. When significant
damage has already occurred, the surgical procedure, Basal Joint Arthroplasty,
removes the arthritic portion of the joint. After surgery, a cast
that includes the thumb and goes above the wrist is worn for four
weeks. Therapy is usually necessary after cast removal. Most patients
can expect to regain pain free thumb function. Complications are infrequent
but real and may include the risks of: surgery, infection, problems
with therapy weakness and stiffness.