Does osteoarthritis of the first carpometacarpal joint limit function of the hand?
Background: Arthritis is the most common cause of disability, and osteoarthritis is the most common form of arthritis affecting the older population. This disease commonly affects the first carpometacarpal joint of the hand and is often debilitating due to pain. The effect on general hand function, however, has not been clearly described. Research on the effects of first carpometacarpal (CMC) joint osteoarthritis (OA), and its limitation on thumb function, is also very limited. Aim: The aim of the proposed study was to determine whether the OA of the first CMC joint limits the function of the hand. The specific objective was to document limitations in hand function in patients with OA of the first CMC joint. Methods: A prospective review of patients presenting with OA of the first CMC joint was done. All male and female patients aged 18 years and older were included in the study. Exclusion criteria included patients unwilling to participate, patients, with carpal tunnel syndrome and trigger finger, pre-existing ipsilateral elbow or shoulder pathology, and patients with ipsilateral peripheral nerve or brachia! plexus injuries. Descriptive statistics were obtained using the Cochin hand function scale as a questionnaire. Results: Forty (40) patients (66 hands) were included in the study, 33 were females and 7 males. The mean age was 70.38 years (SD = 10,058) with a minimum age of 53 and a maximum of 93. Thirty-six (36) of the patients were right-hand dominant and 4 were left-hand dominant. The most common difficulties experienced in the activities of daily living were unscrewing the lid from a jar, buttoning a shirt, squeezing a new tube of toothpaste, writing a letter with an ordinary pen, and picking up coins from a tabletop. Conclusion: OA of the first CMC joint has a greater influence on grip strength, but not as much on the function of the hand.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine