The surgery called a Trapeziectomy involves removing the trapezium bone which is situated at the base of the thumb. By removing this bone it provides more space for the thumb to move and the arthritic bone surfaces are not rubbing together causing pain.
The operation is usually carried out under a general anaesthetic, as a day case procedure. A small incision is made at the base of the thumb to remove the trapezium bone. After surgery the hand will be put into a half plaster and dressings to protect the thumb and this should be kept in place for two weeks until your postoperative appointment. During this time it is important to keep the hand elevated to help get rid of the swelling and to move the fingers to prevent them from getting stiff.
At the two week post-op appointment the dressings and stitches will be removed and the wound checked. A new full plaster will be applied and you should keep the hand dry until the plaster is removed. At four weeks post-op the plaster will be removed. Exercises and advice will be given to gradually increase use of the hand as symptoms and comfort allows. A further follow up appointment will be given and if progress is slow then a referral for physiotherapy/hand therapy will be given.
Recovery to full function of the hand can take a long time, in some cases a number of months. You will probably be able to drive after six weeks as long as you feel comfortable and have regained full finger movement. Returning to work is dependant on the type of work and will need to be discussed with your employer.
All surgery carries a small risk of infection. However, this can be treated with Antibiotics. Pain is normal following surgery but resolves with time and simple painkillers can be used as needed. There is a risk of some sensitivity of the scar and a small area of numbness on the back of the hand and thumb, which may be permanent. Most patients are left with minimal pain and normal hand function, but as with all operations there is a risk of some symptoms persisting and with a trapeziectomy about 1 in 10 patients will have some persisting symptoms.