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Description
Thumb base arthritis involves the Trapezium which is the wrist bone which lies at the bottom of the thumb. Arthritis in this joint is very common and is a progressive condition that leads to stiffness and deformity of the thumb with a corresponding loss of function. In the early stages treatment may be by use of anti-inflammatory medication. Using flexible splints that allow hand function whilst providing some support, can also be useful. Injection of steroid preparations into the joint can sometimes alleviate symptoms temporarily. However, the definitive form of treatment is removal of the arthritic bone at the bottom of the thumb.
The Procedure
The operation is usually performed by giving an anaesthetic to numb the arm. This is commonly combined with a degree of sedation or a general anaesthetic as required. The anaesthetic in the arm lasts for several hours and it can often be the next day before the hand function returns.
Recovery
After surgery, you will be provided with a sling, but this is only usually used for the first day. You will be encouraged to use the fingers to encourage movement and help to reduce the swelling in the hand. The bandage that you wwear after surgery has a splint incorporated in it to protect the thumb. Two weeks after surgery the wound should have healed and the absorbable sutures will start to fall out.
The Hand Therapist will make you a thermoplastic splint which does up with velcro strapping. This is convenient as it allows you to take a bath or a shower and rest the hand out of the splint. You will be given exercises to do at this stage. Hand therapy aims to recover movement of the thumb and improve grip strength. A typical patient has approximately one-third of normal grip strength prior to the surgery and is able to return to two-thirds of normal grip strength after the surgery.
It is important to be aware that the splinting and physiotherapy process lasts a number of weeks and you may not return to all normal activities until this time has elapsed.
