Joints of the Fingers221

Thomas R. Hunt, III

Patients presenting with symptomatic post-traumatic arthritis involving the finger car-pometacarpal (CMC) joints generally complain of localized pain aggravated by gripping, shaking hands, and occupation or sports-specific activities. The majority of these individuals experience episodic, mild symptoms and respond to nonoperative treatment measures. A small percentage require surgical intervention, especially in cases of missed fracture/dislocations and instability. Reconstruction emphasizes stability, with an eye toward mobility for the ulnar column. Degenerative arthritis often manifests as a dorsal bony prominence over the interval between the second and third CMC joints. This osteo-phytic projection is commonly referred to as a dorsal carpometacarpal boss, and may be surgically excised down to normal articular cartilage if symptoms warrant.

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