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