Denervation as a Means of Solving Base of Thumb Arthritis
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Patients who are intolerant of or do not respond to NSAID for the treatment of basilar thumb arthritis suffer pain and weakness of pinch, thus loss of function.  Reconstruction of the basilar thumb joint ties up the hand for about a month and then it takes awhile to get all of the strength back.  There is solid evidence now that thumb denervation through a small incision hurts much less and works very well in a large percentage of the cases in lieu of formal reconstruction.  It does not require prolonged protection, i.e. immobilization.  I have recently just begun offering this, though the concept that has been around for this joint since 1991.  Refinements in the technique are making it much more useful now. 

 

Lorea, Patrick D. “First Carpal-Metacarpal Joint Denervation: Anatomy and surgical technique.”  Techniques in Hand & Upper Extremity Surgery, 7(1): 26-31, 2003. 

Arenas-Prat, JM, Wegner. “Approach for First Carpal-Metacarpal Joint Denervation.” Techniques in Hand & Upper Extremity Surgery, Vol. 16, No. 2; June 2012: pgs. 107-109.  

Dellon, AL. “Volar denervation and osteophyte resection to relieve volar CMC joint pain.” Case Reports in Plastic Surgery and Hand Surgery 2017, Vol. 4, No. 1: 13-16. 

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