Long-term results of thumb carpometacarpal joint arthrodesis

Abstract Introduction Thumb carpometacarpal (CMC 1) arthrodesis remains an established treatment option for patients with high functional demands and strength requirements. Long-term data on mobility, complication rates and clinical outcomes remain limited. This study aimed to analyze long-term clinical and radiological results after CMC 1 arthrodesis. Materials and methods A single-center, retrospective study included patients who underwent CMC 1 arthrodesis between 2004 and 2024. Following medical record analysis, eligible patients were invited to a standardized clinical and radiological follow-up examination. Outcomes included DASH, PRWHE and MHQ scores, pain intensity, mobility, strength and patient satisfaction. Radiological assessment covered fusion signs, implant position and adjacent joint arthrosis. The median follow-up was 9 years. Results 34 patients were included, 16 participated in follow-up. The median DASH score was 14 points, PRWHE 4 points and MHQ 80 (operated) vs. 84 (contralateral). Grip strength reached 85% of the contralateral side, with preserved pinch strength. Compensatory adaptation of adjacent joints was observed regarding range of motion. Patients reported no relevant resting pain and only minimal load-related discomfort. 15 of 16 patients were satisfied with the outcome. Non-union occurred in 4 of 34 cases (11.8%), associated with absent cancellous bone grafting or compression screws. Revision surgery was required in 3 patients, achieving bone consolidation and pain remission in all cases. Radiological follow-up revealed STT arthrosis in 27% of cases, without clinical relevance. Conclusion CMC 1 arthrodesis demonstrates good long-term results with significant pain relief and high patient satisfaction. Mobility compensation and near-complete strength restoration were observed. Adjacent joint arthrosis occurred but remained largely asymptomatic. The use of cancellous bone grafting and compression screws is strongly recommended to reduce non-union risk. Arthrodesis proves a reliable surgical option, particularly for patients with high strength requirements.