Osteoarthritis at the base of the thumb

This is a common condition that particularly affects postmenopausal women. Forces transmitted from the tip of the thumb to the trapezometacarpal joint are amplified resulting in high loads. A complex arrangement of ligaments maintains stability at the joint. An axial grind test can localise the pathology and X-rays will demonstrate degenerative change. Conservative treatment options include hand therapy, behavioural modification, analgesia and splints. Surgical procedures include trapeziectomy, arthrodesis or joint replacement.