The arthritis of the hand refers to the degeneration of the hand joints. There are many causes to consider although in some cases the cause is unknown. The therapeutic approach can be conservative or surgical. Cases characterized by strong pain are generally surgically treated. It is important initially to determine the extent of the wrist joint degeneration. In the case of a panarthrosis( arthritis of all wrist joints) only a surgical reconstruction by means of a prothesis ( implant) or through a surgical stiffening of the affected joints can provide relief. A confined or partial arthritis (for example between the Scaphoid and Trapezium or Trapezoid bones) can be treated exclusive without having to intervene surgically in other wrist joints ( for example partial arthrodeses- immobilisation- of the small joints among themselves). In all cases the therapeutic approach of the presenting problem should be always planned together with the patient during the initial differential assessment since the operations are aimed to relief the patients complaints and not just to restore the pathologic x-ray findings.
Arthritis of the Thumb saddle joint.
The saddle joint of the thumb is located between the basis of the thumb and the wrist bones. Since this joint enables a wide range of movements it could lead over the course of a lifetime to a possible repetitive stress and overload. The resulting complaints can manifest as strong pains or weakness of the thumb. A surgical removal of the worn out trapezium bone (trapeziectomy) as well the suspension of the 1. metacarpal bone with a tendinous strip can alleviate the complaints. Different surgical procedures can be employed depending on the localization of the finger arthrosis (carpometacarpal, proximal or distal interphalangeal joints). The worn out surfaces of the carpometacarpal ( basilar) joint can removed and replaced with a cushion of material that will keep the bones separated (Resection Arthroplasty). In the case of a proximal or distal interphalangeal joint arthrose a surgically induced stiffening following the removal of the deteriorated articular surfaces is appropriate. An artificial joint replacement (Arthroplasty) by means of a prothesis implantation is nonetheless in all cases possible and should be thoroughly discussed with the patient.