What is the trapezium?
The trapezium is the cube-shaped bone in your wrist that is joined to the base of your thumb (trapeziometacarpal joint).
How does osteoarthritis happen?
Osteoarthritis is the most common type of arthritis, where there is gradual wear and tear of a joint.
Osteoarthritis eventually wears away the normal cartilage covering the surface of the joint. The bone underneath becomes damaged, causing joint pain, stiffness and weakness.
What are the benefits of surgery?
The main benefit of surgery is to relieve pain and so improve how your thumb works.
Are there any alternatives to a trapeziectomy?
A splint often helps by restricting the movement of your thumb but you may find that a splint makes it difficult for you to perform normal activities.
A steroid injection into the joint can reduce pain in most people but the symptoms usually come back after several weeks or months.
It is possible to replace the joint with an artificial joint made of metal and plastic in some cases.
What does the operation involve?
Various anaesthetic techniques are possible.
The operation usually takes an hour to 90 minutes.
Your surgeon will make a small cut on the back of your hand at the base of your thumb, and remove the trapezium. Your surgeon may construct a ligament to connect the thumb to your wrist using a tendon that runs over the trapezium.
How can I prepare myself for the operation?
If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.
Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.
What complications can happen?
- Bleeding
- Infection of the surgical site (wound)
- Allergic reaction to the equipment, materials or medication
- Chest infection
- Continued numbness or pain
- Damage to the artery that passes near to the trapezium
- Severe pain, stiffness and loss of use of your hand
- Failure of the operation to improve your symptoms
- Pain
- Unsightly scarring of your skin
How soon will I recover?
You should be able to go home the same day.
Keep your hand raised for 2 weeks.
Speak to your surgeon about when your bandage or cast can be taken off.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.
Your thumb should continue to improve over the next year as you get back a good range of movement.
Summary
Osteoarthritis at the base of your thumb can cause pain when you use your thumb and prevent you from performing normal activities. A trapeziectomy can relieve the pain and so improve how your thumb works.
Keep this information document. Use it to help you if you need to talk to the healthcare team.
Some information, such as risk and complication statistics, is taken from global studies and/or databases. Please ask your surgeon or doctor for more information about the risks that are specific to you, and they may be able to tell you about any other suitable treatments options.
This document is intended for information purposes only and should not replace advice that your relevant healthcare team would give you.
Acknowledgements
Reviewer: Stephen Megson (BSc, MBChB, FRACS), Tim Davis (ChM, FRCS)
Illustrator: Medical Illustration Copyright © Nucleus Medical Art.
All rights reserved. www.nucleusinc.com
This document is intended for information purposes only and should not replace advice your healthcare team gives you. This information is published under license from EIDO Healthcare UK and is protected by copyright. Other than for your personal, non-commercial use, you may not copy, print, download or otherwise reproduce it.
Think you have arthritis in the hand?
Vasudev Shanbhag consults at two locations : St. Joseph’s Hospital at Newport and Nuffield Hereford Hospital at Hereford.