27 Apr CMC joint replacement of the little finger

When this 65-year-old patient, who has congenital central-ray loss in his dominant right hand, presented to London Harley Street hand surgeon, Raj Bhatia, he was suffering from painful arthritis in both his thumb and little finger CMC joint.

X-rays and clinical examination confirmed that while the thumb was causing this gentleman, who works as a software engineer, considerable discomfort, it was the more severely affected little-finger side that was most painful.

Mr Bhatia briefly considered a fusion of the joint, but this would have limited the patient’s function to unacceptable levels, and so opted to perform a CMCJ replacement of the little finger.

Key technical points to consider were the need to angle the cup in a closed orientation and sink it into the hamate for additional support and to ensure immediate primary joint stability.

After four weeks in plaster, the post-op films were taken at an 8-week follow up appointment.

This experimental case study demonstrates that CMC joint replacement, as an alternative to arthrodesis or whole bone removal like a trapeziectomy, is often the treatment that will result in the quickest early return to functional activities, with pain-free movement permitted after just a few weeks.

What a case!