The Condition
You have wear and tear of the joint at the base of your thumb. The base of the thumb
moves on a small box-shaped bone called the trapezium.
This bone in turn articulates with another curved bone – the scaphoid.
There can therefore, be wear and tear above the trapezium or below, but surgical
treatment is the same in that, we remove the trapezium bone. This operation has
been used for 30 years or so, and the results of surgery are excellent. The space
where the bone was fills up with a dense mass of scar tissue. This acts like a “cushion”
and allows the thumb to move quite normally and freely with good pinch grip and
power grip.
The Operation
The operation is done as a “day case” and you will be able to go home the same day
as the operation. The operation is done whilst you are asleep – a general anaesthetic.
The wound is filled with local anaesthetic after the bone is removed. Your hand
will be numb after the operation – this lasts for 8 hours or so. The wound will
be aching after that but not acutely painful. The wound is closed with glue or stitches.
After the Operation
The operation is carried out as a day case. You are kept in a large bandage, which
reduces thumb movement for a period of 3 weeks in total. The bandage keeps the thumb
in the best position for healing.
After removal of the bandage at 3 weeks, we will remove stitches (if they have been
used). You will be encouraged to exercise on your own. The thumb is often uncomfortable
after surgery for 6 – 12 weeks, but bit-by-bit the pain settles and strength and
movement improve.
Pinch grip and power grip, which are very weak before surgery will steadily improve,
after the operation for up to 9 – 12 months after the date of surgery. You will
be encouraged to exercise the hand in warm to hot water as soon as the bandage is
removed. You will not be able to do any harm to your hand and can use it for any
activity you like as soon as the bandage is removed.
Patients who have this wear and tear problem in both hands almost always want the
same operation carried out on the other hand after we have done the first one, because
the operation is so successful !
You will not be able to drive while you are in the big bandage for a period of 3
weeks. You should be able to drive by 4 weeks after surgery.
If you do heavy manual work, you will be unable to work for 6 – 12 weeks after surgery.
If you do light office-type work you will be able to get back to work after 5 or
6 weeks.
Risks of Surgery
- Stiffness of the thumb – occurs in about 2% of all operations
- Weakness of pinch and power grip – occurs in about 2% of all operations
- Infection can occur – as after any cut in the skin, this occurs in about 1% of all operations.
- Sensitivity of the wound – seen in about 1% of all operations.
- Circulation disturbance (sympathetic dystrophy or regional pain syndrome) can occur in approx 1% of all operations. Prompt treatment with medication or injection is
usually very effective. You will be reviewed regularly after surgery so this or any other complication is treated promptly.
In the UK patients need to have their General Practitioner's permission for a referral.
This can be done by means of a phone call after you have described your symptoms , your G.P. will then send a referral letter to my secretary and we will contact
you. Please note the majority of Insurance Companies insist on a GP referral before you are seen.
After you have contacted your G.P. a convenient appointment will be made.
I consult at:
- Sarum Road BMI Private Hospital
- Wessex Nuffield Hospital
- London Bridge Hospital
(For surgery locations please click
here)
Any operative treatment would usually be done at Sarum Road Hospital. Emergency treatment can be carried out on any day.
My secretary can be contacted on Tel. 01962 777616. Futher contact details please click
here.
If my secretary is unavailable you will receive a prompt reply to your answerphone message.