Can a Thumb Injury Lead to Arthritis Later?

If you have thumb pain after an injury, you may wonder if it can turn into arthritis. This study looks at how injuries to the base of the thumb can sometimes lead to a painful condition called rhizarthrosis, also known as thumb arthritis.

Here are three things you should know:

Injuries to the thumb joint can sometimes cause arthritis later.
Treating the injury properly early on helps protect your thumb.
Many treatment options exist if arthritis does develop.

Key Findings at a Glance

The first carpometacarpal joint at the base of the thumb has the highest rate of arthritis of all hand joints.
Posttraumatic arthritis of the thumb is rare but can happen after fractures involving the joint surfaces.
Proper early treatment of thumb injuries reduces the risk of future arthritis.
Trapeziectomy, a surgery to remove a small bone, is considered the gold standard for advanced thumb arthritis.
Additional procedures like suspension or wire placement do not provide significant advantages over trapeziectomy alone.

Why Is the Thumb Joint So Special?

Your thumb is different from your other fingers. It can move in a special way called opposition. This means you can touch your thumb to each of your other fingers. This movement is what lets you pick up objects, write, and do all the delicate tasks your hand can do.

What is the carpometacarpal joint? This is the joint at the base of your thumb where it connects to your wrist. It is sometimes called the CMC joint for short. This joint is shaped like a saddle, which allows your thumb to move in many directions.

According to this study, the first carpometacarpal joint has the highest rate of osteoarthritis of all the joints in the hand. This happens because this joint does so much work every day. Every time you grip, pinch, or hold something, this joint is working hard.

You may be wondering why this matters.

When a joint works hard all the time, it can wear out. Sometimes an injury speeds up this wearing out process. That is what this research is about.

What Causes Thumb Arthritis After an Injury?

Research shows that thumb arthritis caused by injury is actually rare. Most thumb arthritis happens slowly over time without any injury. But when it does happen after an injury, it usually comes from two types of problems.

Fractures That Involve the Joint Surface

A fracture is a broken bone. When the break goes into the smooth surface of the joint, it can cause problems later. According to this study, fractures can involve either the trapezium or the first metacarpal bone.

What is the trapezium? This is a small bone in your wrist that sits right under your thumb. It is shaped like a trapezoid, which is where it gets its name. The first metacarpal is the long bone in your thumb that connects to this wrist bone.

When these bones break and the break goes through the joint, the smooth surface gets damaged. Even when the bone heals, the surface may not be perfectly smooth anymore. This rough surface can lead to arthritis over time.

Dislocations of the Joint

A dislocation happens when the bones in a joint move out of place. The study found that dislocations of the carpometacarpal joint only occasionally lead to arthritis. This means they are less likely to cause problems than fractures that involve the joint surface.

Here is where it gets interesting.

Not every injury leads to arthritis. The key is how well the injury heals and whether the joint surface stays smooth.

Why Does Early Treatment Matter So Much?

The researchers found something important. They discovered that adequate treatment of the injury will minimize the risk for future problems. This means treating your thumb injury properly right away can protect you from arthritis later.

What does adequate treatment mean? It means making sure the bones are lined up correctly and that the joint surface is as smooth as possible. Sometimes this requires surgery. Sometimes it just needs a cast or splint.

Arthroscopy for Early Stage Arthritis

Studies indicate that in early stages of thumb arthritis after an injury, arthroscopy is a valuable method for both diagnosis and treatment.

What is arthroscopy? This is a type of surgery where the doctor uses a tiny camera to look inside your joint. The camera goes through a very small cut. The doctor can see the inside of your joint on a screen and can often fix problems through these small cuts.

This procedure is helpful because it lets doctors see exactly what is happening inside the joint. They can clean out damaged tissue and smooth rough areas. Because the cuts are small, recovery is usually faster than with traditional surgery.

What Surgery Options Are Available?

If thumb arthritis does develop and gets worse, many surgery options are available. The study looked at different types of surgery and compared how well they work.

Trapeziectomy: The Gold Standard

According to this study, advanced osteoarthritis of the first CMC joint is widely treated by trapeziectomy, which is suitable for most patients and considered the gold standard.

What is trapeziectomy? This is a surgery where the doctor removes the trapezium bone, the small wrist bone under your thumb. When this bone is removed, the painful bone on bone rubbing stops. Your body fills in the space with scar tissue, and your thumb can still move and work.

Let us look closer.

The researchers found that many doctors add extra steps to this surgery. Some add suspension procedures. Some put in tissue between the bones. Some use wires to hold things in place temporarily. But here is what the study found: these additional procedures do not provide any significant advantage and lead to comparable results.

This is important information. It means that the simple removal of the bone works just as well as more complicated surgeries. This can mean less surgery time, less cost, and possibly faster recovery.

Treating Hyperextension Problems

The study also found something else important. Research shows that it is advisable to treat hyperextension of the metacarpophalangeal joint of the thumb at any stage of CMC osteoarthritis.

What is hyperextension? This means bending backward too far. The metacarpophalangeal joint is the middle joint of your thumb, where it bends when you make a thumbs up sign. Sometimes when the base joint is arthritic, this middle joint bends backward too much to compensate.

Treating this problem helps your thumb work better. It can be treated at the same time as surgery on the base joint, or separately.

About This Site

This site helps you understand medical science about thumb pain and rhizarthrosis. We read published scientific articles from medical journals and explain them in plain language. Every article on this site is based on real research done by doctors and scientists. We do not make up facts or give opinions. We simply translate the science into words everyone can understand. Feel free to explore more content to learn about your thumb condition.

Frequently Asked Questions

Will every thumb injury cause arthritis?

No. According to this study, posttraumatic arthritis of the thumb is actually rare. It is most likely to happen when a fracture goes through the joint surface. Proper treatment of the injury reduces the risk even more.

What is the best surgery for thumb arthritis after an injury?

Research shows that trapeziectomy is considered the gold standard treatment. This surgery removes the small trapezium bone at the base of the thumb. The study found that adding extra procedures to this surgery does not improve results.

Can early stage thumb arthritis be treated without removing bones?

Yes. Studies indicate that in early stages, arthroscopy can be used to diagnose and treat posttraumatic thumb arthritis. This involves looking inside the joint with a tiny camera and cleaning out damaged tissue through small cuts.

Should I worry about the middle joint of my thumb if I have arthritis at the base?

According to this research, it is advisable to treat hyperextension of the middle thumb joint at any stage of base joint arthritis. This backward bending can cause problems and should be addressed.

Conclusion

Thumb injuries do not always lead to arthritis, but when they do, good treatments are available. The most important thing is to treat any thumb injury properly right away. This gives you the best chance of avoiding arthritis later.

If arthritis does develop, remember that you have options. Early stage arthritis can sometimes be treated with arthroscopy. Advanced arthritis responds well to trapeziectomy, a surgery that has been proven effective over many years.

Talk to your doctor about your specific situation. Every thumb is different, and your doctor can help you choose the best path forward.

Medical Disclaimer

This article is for informational purposes only. It is not medical advice. The information comes from a published medical study and is explained in simple language. Always talk to your doctor or healthcare provider about your specific condition. Do not use this information to diagnose or treat any health problem.

Study Source

This article is based on research by Klenner, A. F., Towfigh, A. H., & Klenner, K., published in Unfallchirurg in 2014.

https://doi.org/10.1007/s00113-013-2508-9

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