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School of Medicine
The Cutting Edge - The Only Option
Cutting Edge Winter 2010
The Only Option
Date: March 1, 2010
When Nancy Grasmick first came to me in 2009, the joints in her hand were all but incapacitated. We tried conservative treatments at first—splints and corticosteroid injections—but, as we always expected, the relief provided by these therapies proved only temporary.
In any area of the body, arthritis is treated with the goal of providing optimal comfort and function. But for severe arthritis like what Nancy dealt with, any treatment less drastic than surgery is almost always an incomplete solution. Sooner or later the pain and loss of movement become unacceptable. When that happens, surgery is often the only remaining option.
In Nancy’s case, the surgery itself, while requiring precision, is less traumatic than the recovery. The procedure requires two incisions—an inch-long cut on the back of the thumb and a smaller opening on the palm-side of the forearm, from which we harvest a section of tendon to reconstruct the basal joint of the thumb. This joint is where Nancy’s problem originated and it’s involved in any motion that involves grip, like opening a door or steering a car.
Once the procedure was over, she still needed several weeks to rest her hand in a splint before she could begin the physical therapy she needed to regain mobility, including the fine motor functions needed for simple tasks like opening jars and fastening buttons. But, while it’s a longer and more demanding ordeal than a shot or brace, surgery guarantees that patients like Nancy can resume their lives without pain or discomfort for the long term.