If you have severe thumb arthritis at the base of your thumb, you may be wondering if surgery can truly help. This study from Italy followed 24 people who had a special type of thumb surgery called the modified Burton-Pellegrini technique. The researchers wanted to see if this surgery would bring lasting relief and give people back their hand strength.
Key Findings at a Glance
- Pain dropped by nearly 77% after surgery
- Grip strength and pinch strength returned to normal levels, similar to the non-operated hand
- Most patients had excellent thumb movement, with 20 out of 24 scoring excellent on function tests
- Only one minor infection occurred, which healed with medicine
- Patients reported high satisfaction and low disability scores on official hand questionnaires
Here are three important things you should know about this research:
- The surgery removed a small bone at the base of the thumb and used a tendon to rebuild support and cushion the joint.
- Patients experienced major pain relief and regained normal strength in their hands.
- This technique is considered a good choice for people with advanced thumb arthritis.
In this article:
- What is rhizarthrosis and why does it hurt so much?
- Who was in this study?
- What surgery did the doctors perform?
- What results did the patients see?
- Why does this matter for you?
- Frequently Asked Questions
- Conclusion
- Disclaimer
- Study Citation
What is rhizarthrosis and why does it hurt so much?
Rhizarthrosis is common in older adults. According to this study, it represents about 10% of all arthritis problems. That means if ten people have arthritis somewhere in their body, one of them has it at the base of the thumb.
The pain happens because the cushion between the bones wears away. When the bones rub against each other, simple tasks like opening a jar or turning a key become very painful.
You may be wondering why this matters. Without that cushion, your thumb cannot move smoothly. It also becomes weak and unstable.
Who was in this study?
The researchers looked back at the medical records of 24 patients. All of these patients had advanced rhizarthrosis. Advanced means the arthritis was in stages two, three, or four according to a grading system created by doctors named Eaton and Littler.
These patients had already tried other treatments that did not work. They needed surgery because their pain was too strong and their thumb function was too poor.
The study tracked how well these people did after their surgery. The goal was to see if the surgery helped them feel better and use their hands more easily.
What surgery did the doctors perform?
The surgery is called the modified Burton-Pellegrini technique. Let us break that down into simple parts.
Step one: removing the damaged bone
The surgeon removed a small bone at the base of the thumb called the trapezium. This bone is shaped like a trapezoid and sits between the thumb and the wrist. When it is damaged by arthritis, it causes pain and grinding.
Removing this bone is called a trapeziectomy. After the bone is gone, there is a space where the thumb bone used to press and rub.
Step two: rebuilding support with a tendon
The surgeon then used a tendon from the wrist to fill that space and create a cushion. A tendon is like a strong cord that connects muscles to bones. In this surgery, doctors used the entire flexor carpi radialis tendon.
This tendon was woven through the bones to hold the thumb in place and provide soft support. This part of the surgery is called ligament reconstruction and tendon interposition. It sounds complicated, but it simply means building a new cushion and support system using your own body tissue.
Here is where it gets interesting. By using your own tendon, the body accepts it well. There is no need for artificial parts or donor tissue.
What results did the patients see?
The researchers measured many different things to see how well the surgery worked. They used official questionnaires and physical tests.
Pain relief
According to this study, patients reported a huge drop in pain. Pain was measured using a scale called the VAS score. This is a simple scale where zero means no pain and ten means the worst pain imaginable.
Research shows that pain decreased by 76.7% after surgery. That means if someone had very strong pain before, it dropped to a much more manageable level after healing.
Hand strength and function
The doctors tested grip strength and key pinch strength. Grip strength is how hard you can squeeze something in your whole hand. Key pinch is how hard you can pinch between your thumb and the side of your index finger, like holding a key to unlock a door.
The results were excellent. Grip strength and key pinch were similar to the strength in the hand that did not have surgery. This means the surgery did not make the hand weaker. Instead, it brought back normal function.
Thumb movement and opposition
The doctors also tested thumb movement using something called the Kapandji test. This test checks if you can touch your thumb to different parts of your hand and fingers. It measures how well your thumb can reach and oppose your other fingers.
According to the findings, 20 out of 24 patients scored excellent on this test. That means most people could move their thumb freely and touch all the important spots on their hand.
Disability and satisfaction scores
Patients filled out two detailed questionnaires. One is called the DASH score and the other is the PRWHE score. Both measure how much your hand problem affects daily life, work, and activities.
Lower scores mean less disability. The average DASH score was 18.8 and the average PRWHE score was 21.7. These are considered very good scores. They mean that most patients felt their hands worked well and did not limit their lives much.
Let us look closer at what this means for real life. Patients could do everyday tasks like cooking, writing, and dressing without major trouble.
Complications
Only one patient had a complication. This was a superficial wound infection. Superficial means it was on the surface of the skin and not deep inside. The infection was treated with antibiotic medicine and healed completely.
No other serious problems were reported. This suggests the surgery is quite safe when done by experienced surgeons.
Why does this matter for you?
If you are living with severe thumb arthritis, you know how frustrating it can be. Simple things like buttoning a shirt or holding a cup can hurt.
This study shows that surgery can bring real relief. It is not just about less pain. It is also about getting back your strength and your ability to use your hand the way you want to.
The choice to have surgery depends on many things. Your age, your job, how active you are, and how bad the arthritis is all matter. The doctors in this study say that surgery should be chosen based on your personal situation and needs.
If other treatments have not worked and your thumb pain limits your life, this type of surgery may be a good option. It has been shown to provide pain relief, stability, and movement.
About this site
This website simplifies medical science for people with thumb pain and rhizarthrosis. We read published scientific articles and translate them into plain language. You do not need a medical degree to understand what research says about your condition. Every article on this site is based only on real studies published in medical journals. We invite you to explore more content and learn what science says about your thumb health.
Frequently Asked Questions
What is the modified Burton-Pellegrini technique?
The modified Burton-Pellegrini technique is a type of thumb surgery. The surgeon removes a small damaged bone at the base of the thumb and uses a tendon from your wrist to create a cushion and support. This helps reduce pain and restore movement.
How much pain relief can I expect after this surgery?
According to research published in 2021, patients in this study experienced a 76.7% reduction in pain after the surgery. Most people reported feeling much better and were satisfied with the results.
Will my hand be as strong as before?
Studies indicate that grip strength and pinch strength returned to levels similar to the non-operated hand. This means the surgery did not make the hand weaker and allowed patients to perform everyday tasks with normal strength.
Are there serious risks with this surgery?
The study reported only one minor complication, which was a surface skin infection that healed with antibiotics. No other serious problems occurred in the 24 patients studied. As with any surgery, risks exist, but this technique appears to be safe when performed by experienced surgeons.
Conclusion
Living with thumb arthritis can be painful and limiting. This research shows that the modified Burton-Pellegrini technique offers lasting relief for people with advanced rhizarthrosis. Patients in this study saw major pain reduction, regained normal hand strength, and were able to move their thumbs freely.
If you are struggling with thumb pain that does not get better with other treatments, talk to your doctor. Ask if this type of surgery might be right for you. Every person is different, and your doctor can help you decide the best path forward based on your unique situation.
You deserve to live without constant pain. You deserve to use your hands freely. This research gives hope that relief is possible.
Disclaimer
This article is for informational purposes only. It is not medical advice. Always consult with a qualified healthcare professional before making any decisions about your health or treatment. Only your doctor can evaluate your specific condition and recommend the right treatment for you.
Study Citation
Authors: Pogliacomi, Francesco; Oldani, Danila; Schiavi, Paolo; Pedrazzini, Alessio; Vaienti, Enrico; Calderazzi, Filippo
Year: 2021
Publication: Acta bio-medica : Atenei Parmensis
Link: https://doi.org/10.23750/abm.v92is3.11578