Rhizarthrosis fourth grade of eaton with hyperextension of the metacarpophalangeal joint.

Introduction: Restoration of thumb function with a painfree, stable, and mobile joint with preserved strength are the main goals of treatment of painful arthritis of the thumb. We present our clinical experience in surgical treatment of this disease, in its highest degree of affectation.

Presentation Of Case: A 57-year-old woman presents with a 2-year history of worsening pain at the base of her right, dominant, trapezial-metacarpal (TM) joint. Her thumb metacarpophalangeal (MCP) joint hyperextends 30° with lateral pinch. Radiographs demonstrate Eaton stage IV degenerative changes of her TM joint and no arthritis of her thumb MCP joint. She was successfully treated with a modified Burton-Pellegrini arthroplasty and sesamoidesis to the metacarpal head.

Discussion: In cases of advanced rhizarthrosis conventional surgery does not serve to correct deformities of the metacarpophalangeal joint that may affect to the postsurgical outcomes.

Conclusion: rhizarthrosis management must be carried out in a global way. When a surgical treatment is planned, all deformities must be taken into account.