Surgical measures are considered only if conservative measures do not lead to the desired success:
- Rhizarthrosis: resecting arthroplasty – gold standard; in long-term studies, very good to good results were achieved in 80-95%; the procedure (see below thumb saddle arthrosis (rhizarthrosis)/operative therapy); if necessary, also arthrodesis (stiffening surgery) or endoprosthetic replacement of the thumb saddle joint (this procedure has not yet become established as a standard procedure).
- Thumb metacarpophalangeal joint (synonym: Articulatio metacarpophalangealis pollicis): arthrodesis (fusion surgery).
- Thumb interphalangeal joint: arthrodesis (fusion surgery) with double-threaded screws.
- Finger metacarpophalangeal joint (lat. Articulationes metacarpophalangeae (MCP): silicone placeholder – gold standard; it is a mobility-preserving surgical procedure.
- Finger middle joints (located between articulationes interphalangeales proximales (PIP) and finger end joints (articulationes interphalangeales distales (DIP)) prosthetic fitting (relatively high complication rate).
- Proximal interphalangeal joint (PIP or PIG; joint between the proximal phalanx (base phalanx) and the medial phalanx (middle phalanx) of a finger): endoprosthetic joint replacement for the finger middle joint; results in functional improvement with pain reduction; complication rate of these prostheses is increased compared with the proven silicone placeholder
- Distal interphalangeal joint (DIP or DIG; joint between the phalanx media (middle phalanx) and the phalanx distalis (distal phalanx) of a finger): Arthrodesis (fusion surgery) is considered a reliable method with a very high consolidation rate and patient satisfaction.
