STT (scaphotrapezotrapezoidal) joint arthritis Discussion

Degenerative arthritis of the STT (scaphotrapezotrapezoidal) joint of the thumb commonly develops as a result of normal use and the natural aging process. Nonoperative treatment options include rest, splinting, therapy, oral anti-inflammatory medication, and intraarticular steroid injection. Pain and progressive loss of motion may occur with conservative management due to progressive arthritis. Progressive joint deterioration may occur. Surgical options include either joint fusion or arthroplasty. Total joint reconstruction requires trapeziectomy and soft tissue reconstruction, and often involves partial trapezoid excision and debridement of the index metacarpal base. Fusion may require bone graft, and often results in enough loss of mobility of the thumb that the palm cannot be placed in full contact with a flat surface. Surgery has the risks of persistent soreness, painful neuroma, instability of the thumb, weakness and numbness. Postoperative immobilization and therapy is essential. Surgery usually requires approximately three months for recovery and soreness may persist for a year after successful surgery. An average of one out of three patients will have some degree of persistent pain, deformity or weakness despite surgery.

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