SCAPHO-TRAPEZIUM-TRAPEZOID ARTHRITIS


STT Arthritis (scapho-trapezium-trapezoid arthritis) is a rare form of arthritis involving a very specific joint, the scaphoid-trapezio-trapezoid joint. It usually presents with pain on the front side of the palm, on the thumb side.

The condition is poorly understood as it affects a very specific joint and is associated with flexor carpi radialis (FCR) tendon synovitis, with the development of a bony tunnel around this tendon as it runs over the STT joint.

Any wrist movement towards the thumb side will compress the joint. Over time, with loss of all cartilage in this joint, there will be severe pain with most wrist movements, making a fist and using the thumb.

Conservative treatment for STT arthritis is initially anti-inflammatories, cortizone injection and even wrist splinting, but in the long term with progressive joint deterioration and complete loss of cartilage, the pain is produced by bone grinding on bone and severe inflammation of the overlying FCR tendon.

If pain becomes disabling and incapacitates activities of daily living, a small procedure that excises the distal pole of the scaphoid, called an excision arthroplasty, is performed to create a void between the bone surfaces that are grinding on each other causing the pain. This void is then filled up with an interposition of a small piece of the tendon that creates pain free articulation.

Rehabilitation includes 2 weeks of immobilisation in a post surgery thumb cast. This is then replaced with a thermoplastic thumb and wrist splint and range of movement exercises and light activities are gradually introduced at 4-6 weeks post surgery. Most patients do well and can start using their wrists after three to four months without pain.

SCAPHO-TRAPEZIUM-TRAPEZOID ARTHRITIS


STT Arthritis (scapho-trapezium-trapezoid arthritis) is a rare form of arthritis involving a very specific joint, the scaphoid-trapezio-trapezoid joint. It usually presents with pain on the front side of the palm, on the thumb side.

The condition is poorly understood as it affects a very specific joint and is associated with flexor carpi radialis (FCR) tendon synovitis, with the development of a bony tunnel around this tendon as it runs over the STT joint.

Any wrist movement towards the thumb side will compress the joint. Over time, with loss of all cartilage in this joint, there will be severe pain with most wrist movements, making a fist and using the thumb.

Conservative treatment for STT arthritis is initially anti-inflammatories, cortizone injection and even wrist splinting, but in the long term with progressive joint deterioration and complete loss of cartilage, the pain is produced by bone grinding on bone and severe inflammation of the overlying FCR tendon.

If pain becomes disabling and incapacitates activities of daily living, a small procedure that excises the distal pole of the scaphoid, called an excision arthroplasty, is performed to create a void between the bone surfaces that are grinding on each other causing the pain. This void is then filled up with an interposition of a small piece of the tendon that creates pain free articulation.

Rehabilitation includes 2 weeks of immobilisation in a post surgery thumb cast. This is then replaced with a thermoplastic thumb and wrist splint and range of movement exercises and light activities are gradually introduced at 4-6 weeks post surgery. Most patients do well and can start using their wrists after three to four months without pain.

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