Role of First Metacarpal Osteotomy in the Management of Basilar Thumb Arthritis


This study reviews outcomes of patients undergoing Wilson extension osteotomy of the first metacarpal for treatment of carpometacarpal (CMC) joint pain and deformity. The study reviews varied indications for Wilson osteotomy outlining technique and functional outcomes. Twelve patients (11 female, 1 male) with an average age at surgery of 50 (range, 25–67) underwent osteotomy during the study period. Diagnoses included seven patients with early degenerative changes of the CMC joint with painful subluxation or instability. The remaining patients had symptomatic adduction contracture in either end-stage arthritis (three) or following prior trapeziectomy (two). Average motion improved modestly among all groups with considerable improvement of metacarpophalangeal hyperextension in late deformity patients. Wilson osteotomy is a motion-preserving alternative procedure that may be indicated for patients with early CMC arthrosis and instability as well as for patients with adduction contractures in end-stage arthritis or posttrapeziectomy (Journal of Surgical Orthopaedic Advances 28(1):63–67, 2019)
Key words: basilar thumb arthritis, corrective osteotomy, first metacarpal osteotomy, metacarpal osteotomy, Wilson extension osteotomy

Maureen O’Shaughnessy, MD; Megan Conti Mica, MD; and Marco Rizzo, MD