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Advice on Trapeziectomy

Before embarking on trapeziectomy you should be aware of the following facts. If you have any other questions you should ask your surgeon for further information.

Benefits
Trapeziectomy is performed for arthritis at the base of the thumb. It involves removal of a small bone called the trapezium

• Surgery is likely to significantly improve the pain and stiffness caused by the arthritis
• Function is greatly improved but never returns to normal (i.e. the state prior to the onset of arthritis). Strength normally returns to about 90% of a non-diseased thumb

Risks

• Infection: All surgery carries a small risk of infection; the risk is small and can normally be treated with antibiotics

• Pain:  Pain is normal following surgery, but normally resolves after a few months. In some cases however  there may be a degree of persistent pain

• Reflex sympathetic dystrophy:  Extremely rarely a condition known as reflex sympathetic dystrophy (RSD) may develop immediately after surgery; the hand becomes very swollen, painful and stiff. Treatment involves physiotherapy and occasionally injections into the arm. Full recovery from this condition may take may months.

Surgery details

• Surgery will be done under general or regional anaesthesia. It cannot be done under local anaesthetic.

• An incision is made over the back of the thumb base. Sometimes a second incision is made over the front of the forearm. If the deformity is severe it may be necessary to hold the thumb in position by means of a wire. This is left protruding from the skin so that it can be easily removed in a few weeks.
  The thumb will be immobilized in a dressing incorporating a plaster

• You may be asked to stay in hospital overnight

• Stitches will be removed after about 1 week

• The plaster will usually be exchanged to a removable splint at 3 weeks. If a wire has been inserted this will be removed at this time

• A course of physiotherapy will be necessary to help regain thumb movement

Recovery

• Mild pain is normal for several days following surgery and you may need to take a painkiller such as paracetamol

• You should keep your hand dry until the plaster is removed

• You may use the hand as much as you find comfortable

• You will not be able to do light household duties within about 1 month. Heavy activities such as gardening will not be possible for at least 3 months

• You may return to work as soon as you feel able but note that you are not allowed to drive whilst wearing a plaster or a splint

 

For further information please see  www.johnbritton-orthopaedics.co.uk

John Britton FRCS
Consultant Orthopaedic Surgeon