Our Summary

This research paper discusses the thumb’s base joint, which is vital for hand function. This joint has a unique design that allows a wide range of movement, but it’s also unstable because it depends on soft tissues for support rather than fitting together well with the bones. This instability can cause pain due to several reasons, such as trauma, natural flexibility conditions, and constant overuse and minor injuries.

To properly diagnose this instability, one needs to take into account the patient’s medical history, perform a thorough examination, and use appropriate imaging techniques. The treatment can be non-surgical or surgical, with the latter involving various methods to repair or rebuild the ligaments. A type of minimally invasive surgery called arthroscopy can also be helpful in assessing the joint and stabilizing the important soft tissues.

The paper provides a detailed explanation of the bone and soft tissue anatomy around the thumb’s base joint. It also discusses the important considerations when evaluating patients who have instability in their thumb’s base joint due to trauma or chronic conditions, but do not have fractures or arthritis. It also reviews both non-surgical and surgical treatment options for this kind of injury.

FAQs

  1. What are the different treatment options for instability of the thumb’s basal joint complex?
  2. How does arthroscopy help in the assessment and stabilization of the thumb’s basal joint complex?
  3. What is the process of evaluating patients with acute traumatic and chronic thumb carpometacarpal instability without fracture or arthritis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about wrist arthroscopy is to follow the post-operative care instructions closely to ensure proper healing and optimal outcome. This may include keeping the wrist elevated, performing prescribed exercises to regain strength and mobility, and avoiding certain activities that could put strain on the wrist during the initial recovery period. It is also important to attend follow-up appointments with the doctor to monitor progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended wrist arthroscopy include those with:

  1. Persistent wrist pain or swelling that does not improve with conservative treatment methods such as rest, ice, and physical therapy.
  2. Wrist injuries that have not responded to other diagnostic tests such as X-rays or MRI.
  3. Suspected ligament tears or cartilage damage in the wrist joint.
  4. Chronic wrist conditions such as carpal tunnel syndrome, wrist arthritis, or ganglion cysts.
  5. Patients who have undergone previous wrist surgeries and are experiencing continued pain or limited range of motion.
  6. Patients with suspected wrist fractures or other bony abnormalities that may require surgical intervention.

Timeline

  • Before wrist arthroscopy:
  1. Patient may experience symptoms such as pain, swelling, and limited range of motion in the wrist.
  2. Patient undergoes a thorough history and physical examination by a healthcare provider to evaluate the extent of the wrist injury.
  3. Imaging studies such as X-rays, MRI, or CT scans may be ordered to further assess the internal structures of the wrist.
  4. Nonoperative treatment options such as rest, ice, physical therapy, and medications may be recommended to alleviate symptoms and improve function.
  5. If nonoperative treatments are not effective, surgery may be recommended, including wrist arthroscopy as a minimally invasive option.
  • After wrist arthroscopy:
  1. Patient undergoes the arthroscopic procedure, where a small camera and instruments are inserted into the wrist joint to visualize and treat any abnormalities.
  2. Recovery from wrist arthroscopy is typically quicker than traditional open surgery, with less pain and scarring.
  3. Physical therapy may be prescribed to help restore strength and range of motion in the wrist.
  4. Follow-up appointments with the surgeon are scheduled to monitor the healing process and address any concerns or complications.
  5. Patient gradually resumes normal activities and may experience improvement in symptoms and function of the wrist over time.

What to Ask Your Doctor

  1. What is wrist arthroscopy and how can it help with my wrist pain or instability?
  2. What are the potential risks and complications associated with wrist arthroscopy?
  3. How long is the recovery time after wrist arthroscopy and what can I expect during the recovery process?
  4. Are there any alternative treatments to wrist arthroscopy that I should consider?
  5. How experienced are you in performing wrist arthroscopy procedures?
  6. What is the success rate of wrist arthroscopy in treating wrist pain or instability?
  7. Will I need physical therapy after the procedure, and if so, for how long?
  8. How long will the effects of wrist arthroscopy last, and will I need any additional treatments in the future?
  9. Can you explain the specific techniques and procedures you will be using during my wrist arthroscopy?
  10. Are there any specific precautions or instructions I should follow before and after the wrist arthroscopy procedure?

Reference

Authors: Rabinovich RV, Polatsch DB, Shin SS, Beldner S. Journal: J Am Acad Orthop Surg. 2021 Nov 15;29(22):943-950. doi: 10.5435/JAAOS-D-21-00310. PMID: 34271570