Name of the Procedure:

Arthrodesis, Carpometacarpal Joint, Digit, Other Than Thumb, Each; With Autograft (Includes Obtaining Graft)

Summary

Arthrodesis of the carpometacarpal joint is a surgical procedure that involves the fusion of bones in the joint located at the base of a finger (excluding the thumb) using bone obtained from the patient’s own body (autograft). This surgery is performed to alleviate pain and restore stability and function.

Purpose

The procedure is performed to reduce persistent pain in the carpometacarpal (CMC) joint caused by arthritis or injury. By fusing the joint, the surgery aims to provide pain relief and improve the function of the finger, preventing further joint degeneration.

Indications

• Severe arthritis in the CMC joint
• Chronic pain and inflammation in the finger joint
• Instability or deformity of the CMC joint
• Failure of conservative treatments like medication or physical therapy

Preparation

• Fasting for 6-8 hours before the procedure
• Adjusting or stopping certain medications as directed by the doctor
• Undergoing pre-operative blood tests, X-rays, or MRI scans

Procedure Description

1. Anesthesia: The patient is administered either general anesthesia or regional anesthesia to numb the surgical area.
2. Incision: A small incision is made over the CMC joint of the affected finger.
3. Preparing the Joint: The surfaces of the bones in the joint are roughened or trimmed.
4. Harvesting Graft: Bone graft material is taken from another part of the patient's body, often from the pelvis.
5. Fusion: The graft is placed between the bones of the CMC joint to be fused and might be secured using screws, plates, or wires.
6. Closure: The incision is closed with sutures, and the area is bandaged.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This surgery is performed in a hospital operating room or a surgical center.

Personnel

• Orthopedic surgeon or hand surgeon
• Anesthesiologist
• Surgical nurses

Risks and Complications

• Infection at the surgery site
• Nonunion (failure of the bones to fuse properly)
• Delayed healing
• Nerve injury leading to numbness or weakness
• Pain at the graft harvest site

Benefits

• Significant pain relief
• Improved finger stability and function
• Prevention of further joint degeneration Benefits are often realized within several weeks to months post-surgery.

Recovery

• Immobilization of the finger with a splint or cast for several weeks
• Post-operative pain management with medications
• Physical therapy to restore movement and strength
• Full recovery typically takes a few months, with some activity restrictions

Alternatives

• Non-surgical treatments like anti-inflammatory medications, steroid injections, and physical therapy
• Joint replacement surgery Non-surgical treatments may offer temporary relief but do not address severe joint degeneration like arthrodesis.

Patient Experience

• During the procedure: The patient will be under anesthesia and will not feel pain.
• After the procedure: There may be some discomfort or pain managed with medications. The patient will need to keep the finger immobilized and follow post-operative care instructions to ensure proper healing.