Trapeziectomy

The trapezium is one of the eight carpal (wrist) bones and is situated at the base of the thumb. Arthritis in this joint is very common and is contributed to by instablity of the joint and vulnerability to wearing of the joint surfaces. The condition is progressive and results in stiffness and deformity in the thumb. If the condition is neglected the joint will probably stiffen.

The condition may be treated by reducing activity, painkillers, splints, steriod injections and surgery.

Surgery is the only definitive treatment of persistent symptoms.

THE PROCEDURE

The operation is usually performed under general anaesthetic supplemented by local anaesthetic and will involve a one night stay in hospital.

Trapeziectomy involves the complete removal of the trapezium bone which is necessary if the joints both above and below the trapezium are arthritic.

FOLLOWING SURGERY

The hand will be dressed and a plaster applied to protect the surgery. It is very important that the hand is elevated to prevent swelling and stiffness of the fingers and movement of the hand and thumb tip should be carried out. Light activities may be carried out following surgery.

Two weeks post-operatively the stiches will be removed and a lighter splint applied. There will be some swelling and bruising.

Four weeks post-operatively you can begin to remove your splint during the day for light use. It may be worth wearing the splint for protection at night for up to six weeks following surgery.

Six weeks following surgery the splint is no longer necessary at night.

Eight weeks after surgery you will have a scar on the back of the thumb which will be tender and firm to touch. This may be eased by massaging the area firmly with moisturiser.

Eight to twelve weeks post-operatively you will be able to drive if you are comfortable to do so and have regained full finger movement. Returning to work depends upon your occupation and this should be discussed.