If you have severe pain at the base of your thumb, you know how hard it is to open a jar or hold a pen. Every small task can feel hard. This study looks at a surgery called arthrodesis. This big word means the bones are fused so the joint does not move. Doctors did this surgery on 14 thumbs in 12 people. The results are hopeful.
Key Findings at a Glance
- According to research published in Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca, all 14 thumb joint fusions healed completely with no complications.
- Studies indicate that painful grip improved in most patients after surgery.
- Research shows that hand grip strength increased by an average of 35 percent after the procedure.
- Medical evidence from this study found that 64 percent of patients had excellent or very good outcomes using the Cooney scoring system.
- Patients were followed for an average of 5 years after surgery.
In this article:
- What is thumb joint fusion?
- Who needs this surgery?
- How does the Carroll technique work?
- What did the study find?
- Who benefits most from this surgery?
- Frequently asked questions?
- Conclusion
- Disclaimer
- Scientific Source
What is thumb joint fusion?
Thumb joint fusion is a surgery where two bones in your thumb are joined together permanently. The joint at the base of your thumb is called the carpometacarpal joint, or CMC joint for short. This is the joint where your thumb meets your wrist.
When this joint becomes very damaged by arthritis or injury, moving it hurts. Sometimes the joint becomes so unstable that your thumb wobbles or feels weak. Fusion stops the movement. That also stops the pain.
You may be wondering why doctors would want to stop your thumb from moving. Here is why. When the joint is very damaged, movement causes pain every time you use your hand. By joining the bones together, the pain goes away. Your thumb becomes stable and strong again.
Who needs this surgery?
According to this study, thumb joint fusion is most often done for people with stage III rhizarthritis. That is a medical term for severe arthritis at the base of the thumb. The doctors use something called the Eaton classification to measure how bad the arthritis is. Stage III means the damage is quite serious.
This arthritis can happen for different reasons. Some people get it as they age. Others get it from rheumatic diseases. These are conditions where the body attacks its own joints. Still others develop it after an injury to the thumb.
The surgery is also done sometimes for people whose thumb joint is very unstable. This usually happens after a serious injury. The joint moves too much in the wrong directions. This makes it hard to grip things。
How does the Carroll technique work?
The doctors in this study used a method called the Carroll technique. This is a specific way of doing the fusion surgery. Let us look closer at what happens during this surgery.
First, the surgeon shapes the bottom of the thumb bone into a cone shape. Think of it like sharpening the end of a pencil. Then the surgeon shapes the top of the wrist bone to match. The wrist bone gets a hollow that fits the cone perfectly.
Next, the surgeon fits these two shaped bones together. They lock into place like puzzle pieces. Then the surgeon inserts thin metal wires called Kirschner wires. These wires hold the bones in the right position while they heal and grow together.
Here is where it gets interesting. The cone shape helps the bones stay in the right position. It also gives a large surface area for the bones to grow together. This makes the fusion very strong.
What did the study find?
Research shows that the surgery worked very well for all 14 thumbs. Between 1990 and 2005, doctors performed the surgery on 12 patients. Some patients had both thumbs done. The doctors then followed these patients for about 5 years on average.
Every single thumb healed completely. The bones grew together as planned. There were no cases of pseudoarthrosis. That is a medical term for when the bones fail to join together properly.
According to medical evidence from this study, most patients felt much less pain when gripping things. Before surgery, holding objects hurt. After surgery, the pain was gone or much better. The patients still could not move that joint because it was fused. But now the lack of movement was painless.
Studies indicate that grip strength improved dramatically. On average, patients could squeeze 35 percent harder after surgery compared to before. That is a big improvement. It means they could do more tasks with their hands.
The doctors measured overall success using something called the Cooney score. This is a scoring system that looks at pain, function, movement, and grip strength together. Medical evidence found that 64 percent of patients scored excellent or very good on this scale.
| What Was Measured | Result |
|---|---|
| Complete bone fusion | 100 percent success |
| Pain with gripping | Improved in most patients |
| Grip strength increase | 35 percent on average |
| Excellent or very good outcomes | 64 percent of patients |
Who benefits most from this surgery?
The doctors who did this study shared their thoughts on who should get this surgery. They believe it works best for certain people. Let me explain who they are.
According to this study, middle aged men who do hard physical work with their hands benefit most. These are people who need a strong, stable thumb for their jobs. They need to grip tools or lift heavy things. For them, a pain free thumb with good strength is more important than having full movement.
The surgery is best for people with stage III rhizarthritis according to the Eaton classification. This means the arthritis is advanced. Other treatments have probably already been tried without success.
There is one important point to remember. The doctors say this surgery should only be done if the other joints in the thumb are healthy. If you have arthritis in multiple thumb joints, this surgery might not be the best choice. Fusing one joint puts more stress on the other joints. If those joints are already damaged, you could have problems.
Research shows that people with unstable CMC joints also do well with this surgery. These are usually people who had a bad injury to the thumb. The joint moves too much. It feels wobbly. Fusing it makes it stable again.
What about the position of the thumb?
One important part of this surgery is setting the thumb in the right position before fusing it. Once the bones grow together, the thumb will stay in that position forever. So getting it right matters a lot.
The surgeon positions the thumb so it can still work well for gripping. Even though the base joint will not move, the other joints in your thumb still will. You will still be able to pinch and grasp. The fused joint gives you a stable base to work from.
How is the joint held in place?
In this study, the doctors used Kirschner wires to hold the bones together while they healed. These are thin metal pins. They are temporary. Once the bones have grown together firmly, the wires can be removed.
The study mentions that there are other ways to hold the bones in place too. Some surgeons use plates and screws instead of wires. Each method has benefits. The important thing is that the bones are held firmly in the right position until they fuse.
Frequently asked questions?
Will I lose the ability to use my thumb after fusion surgery?
According to this study, you will lose movement at the base joint of your thumb, but the other joints still move. Research shows that grip strength actually improves by 35 percent on average. Most patients can do daily tasks better after surgery because the pain is gone and the thumb is stable.
Does the bone fusion always work?
Medical evidence from this study found that all 14 thumb fusions healed completely. There were no cases of the bones failing to join together. This is an excellent success rate. The Carroll technique seems to be very reliable for achieving solid bone fusion.
How long does it take to recover?
The study does not give specific recovery times, but it does say that patients were followed for an average of 5 years. The bones need time to grow together firmly. During that time, the Kirschner wires hold everything in place. Your doctor will tell you when it is safe to use your thumb fully again.
Is this surgery right for everyone with thumb arthritis?
According to this study, the surgery works best for middle aged people who do manual work and have stage III rhizarthritis with healthy other thumb joints. If you have arthritis in multiple thumb joints or if you are older with less physical demands, your doctor might suggest different treatments. Each person is different.
Conclusion
Thumb joint fusion using the Carroll technique can be a very effective treatment for severe thumb arthritis and unstable thumb joints. Research shows that it relieves pain, increases grip strength, and gives the thumb stability.
The results from this study are encouraging. Every patient healed well. Most felt much better. Their thumbs became strong and useful again.
If you are struggling with severe thumb pain that makes daily tasks hard, talk to your doctor. Ask if thumb joint fusion might be right for you. Bring up the Carroll technique. Discuss your work and your needs. Together you can decide on the best path forward.
Remember, this surgery is not for everyone. But for the right person, it can make a real difference in quality of life.
About This Site
This website simplifies medical science to help you understand thumb pain and rhizarthrosis better. We use only published scientific articles as our sources. We translate complex medical research into plain language that anyone can understand. We invite you to explore more articles on our site to learn about treatment options, diagnosis, and ways to manage your symptoms.
Disclaimer
This article is for informational purposes only. It is not medical advice. Always consult with a qualified healthcare provider before making any decisions about your treatment. Your doctor knows your individual situation and can guide you to the best options for your specific needs.
Scientific Source
Lutonsky, M., & Pellar, D. (2006). Arthrodesis of the carpometacarpal joint of the thumb. Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca.
https://doi.org/10.55095/achot2006/050