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The Radiologic Prevalence of Trapeziometacarpal Arthrosis
David C. Ring, MD; Stéphanie Becker; Jan Paul Briet; Michiel Hageman
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston

Purpose: Our primary study question addressed the radiographic prevalence of trapeziometacarpal (TMC) arthrosis at different age groups in patients who presented with a distal radius fracture. We also tested for differences by age and sex.

Methods: A total of 2321 patients 31 years or older with radiographs obtained during treatment of a distal radius fracture between 2002 and 2012 were analyzed. Trapeziometacarpal arthrosis was graded using the 3-point scale of Sodha et al. (none, definite, destroyed TMC joint).

Results: Three patients had evidence of prior surgery for TMC arthrosis and were not included in the analysis. Trapeziometacarpal arthrosis was noted from 31 years onwards. Its prevalence vastly increased from 17% to 45% between the ages of 41 to 50 years and 51 to 60 years, respectively. The prevalence steadily increased to 85% between the ages of 71 and 80 years, and reached 100% in women (50% severe) aged 91 years or older and 93% in men of 81 years or older. Severe arthrosis was more prevalent at earlier ages amongst women and reached 35% in women and 34% in men who were 81 years or older. Logistic regression identified higher age (odds ratio (OR) = 2.6 per 10 year interval) as the strongest factor associated with TMC arthrosis, but sex (women; OR = 1.3) was also a factor.

Discussion: Age was the most important predictor for evidence of TMC arthrosis and more severe disease. If you live long enough, you get TMC arthrosis. This combined with the fact that only three patients had evidence of prior surgery suggests that most people adapt to TMC arthrosis. Treatments that optimize adaptation in patients that present with symptoms and disability related to TMC arthrosis merit additional study.

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