Hand

Post-operative instructions following Trapeziectomy

First 48 hours

  • Keep the hand elevated
  • Move the fingers, elbow and shoulder as much as possible
  • The local anaesthetic will wear off a few hours after the operation and when it does so the hand will be painful. Take painkillers such as codeine and paracetamol as required.
  • Use the hand for simple every day activities, but use is quite limited by having the thumb included in the plaster cast.

12 to 14 days post-operation

  • You will have an appointment at the hospital.
  • The plaster of Paris backslab and sutures used to close the wound will need to be removed.
  • A new cast will be applied.
  • Continue to keep the hand elevated, move the fingers and use the hand for simple activities.

4 weeks after the operation

  • You will have another appointment at the hospital and the cast will be removed.
  • Once the cast has been removed you can wash the hand normally
  • Start massage the scar with a moisturising cream such as E45 3 times a day.
  • The thumb and wrist will be stiff, and you will be shown exercises to get them moving.
  • You can start using the hand for activities and return to driving as you feel able to do so.

Potential complications and expected recovery

  • Use of the hand steadily increases. The pain, strength and stiffness will slowly recover. This can continue for several months, with some patients continuing to improve for a year after the operation. About one in ten patients will continue to have symptoms to a varying degree in the long term.
  • There may be an area of numbness beyond the scar on the back of the thumb. This can take several months to recover, and recovery cannot be guaranteed.
  • There is a small risk of a wound infection. If this occurs there will be swelling, redness and possibly discharge from the wound. If this occurs it will usually settle with a course of antibiotics.
  • The scar can be tender. Massaging it once the cast has been removed helps with this.
  • The thumb can be stiff and not recover a normal range of movement
  • Some patients will develop a condition called complex regional pain syndrome after their trapeziectomy. The severity of symptoms and how long they last is variable, but can affect about 1 in 20. When severe the hand is painful, stiff, hypersensitive, and may be swollen, sweaty, hot and blotchy.
  • In a small minority of patients the pain does not improve with the operation and may even be worse
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