Let me tell you, folks, when it comes to fixing up those thumbs, especially the thumb metacarpophalangeal (MP) fusion, we’re talking about a procedure that’s usually a huge success. But, and it’s a big but, there’s always a chance things might not go as planned. We’ve seen complications in, believe it or not, up to 30% of cases. And nonunions? They can happen up to 15% of the time. That’s right, not all techniques are created equal.

Now, we looked back, all the way from 2000 to 2022, at folks who had this thumb MP fusion done. And let me be clear, we’re talking about the first time around, no do-overs. We checked out everything – who these people were, what went wrong, how long it took to heal, you name it. And we had a lineup of techniques – staples, Kirschner wires (K-wires), cerclage, a combo of K-wires and cerclage, and the intramedullary screw. A real variety show.

Here’s the deal: 47 brave souls went with staples, 16 with K-wires, 14 chose cerclage, 9 went for the combo, and 6 took a chance on the intramedullary screw. And guess what? The screw, folks, it didn’t hold up too well. We’re talking a statistically higher rate of nonunion. That’s science talking.

And if you’re smoking, have diabetes, or carrying a few extra pounds, well, you’re in for a rougher ride. These factors? They’re like kryptonite to your chances of a smooth fusion.

So, what’s the bottom line here? If you’re thinking about getting that thumb MP fusion, and someone suggests an intramedullary screw, you might want to think twice, especially if you’re smoking, diabetic, or overweight. We want you to have the best, folks, the absolute best. Remember, not all fusion techniques are the same. Choose wisely!