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