Thumb Arthritis

Arthritis of CMC joint is the most common arthritis of hand joint.
more common in women (upto 1/3 of women over age 40, will have x-ray changes);
    - may exist in a localized form or may exists as a systemic form of arthritis;
    - primary form is most common in post-menopausal women;
    - systemic form may be due to rheumatoid arthritis or gout.


LRTI: The most useful surgery for thumb arthritis
LRTI involves partial or complete resection of the trapezium and recreation of the palmar oblique ligament using the distally based radial half of a tendon called FCR to reconstruct ligamentous support for the metacarpal;
    - supporting ligamentous sling is made by passing tendon thru center of base of metacarpal and its unlnar cortex;this maintains length and prevents radial subluxation;remaining tendon is folded & placed into area of absent trapezium.

    - patients can expect significant long term increases in grip and pinch strength following this procedure.
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