Solutions to Two Difficult Surgical Problems in Musicians: Modified Surgical Techniques for Basal Thumb Arthritis and Trigger Finger

Abstract

Basal thumb joint arthritis and trigger finger are problems encountered in musicians. Routine surgical procedures to treat these disorders in the general population yield predictable results with good functional outcome. However, in piano players, routine arthroplasty of the thumb carpometacarpal (CMC) joint cannot meet the specific demands of full opposition/rotation and extension/span. In guitar players and string players, standard release of the A1 pulley for trigger finger can compromise fine distal control of the fingertip in extreme flexion. In this paper, we describe modifications of these procedures tailored to meet the functional demands of pianists, violinists, and guitarists.