PMC5315005_01
Radiographs of the patient who is described in Case #1, and who is patient #2 in Table 1. Radiograph in (A) shows the right first metacarpal trapezial joint pre-operatively and (B) shows the pan-osteoarthritis also on the left side.
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F0001
Two previous hand surgery consultations both had suggested surgical treatment, either with a CMC fusion or resection-implant arthroplasty based upon her radiographic appearance (Figure 1).
Intra-operative views of same patient as in Figure 1. (A) The innervation to be resected. (B) After osteophyte removal.
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F0002
The intra-operative views from the surgery on the right CMC are given in Figure 2.
Clinical views of same patient as in Figure 1. Five years following bilateral volar CMC denervation, piano playing is possible without volar CMC joint pain.
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F0003
Post-operatively, she was able to resume her medical practice and musical instruments playing without the previous pain (Figure 3).
PMC5315005_02
(A) Intra-operative view of the innervation to the left CMC joint and (B) a clinical bilateral view of the patient pinching without pain five years following the bilateral partial CMC joint denervation. This is the patient described in Case #2, who is patient #3 in Table 1.
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F0004
Figure 4 demonstrates the intra-operative view of the nerve prior to resection, and a five-year follow up of him pinching bilaterally without pain.
Radiographs of the same patient described in Figure 4. (A) Pre-operative view of the left CMC joint and (B) five year post-operative view of the same joint.
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F0005
The radiographic comparison of the right CMC joint pre-op and five years post-operatively is seen in Figure 5.