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
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