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The procedure to put in the prosthesis implant takes about two hours to complete.  Surgery will be done using a general anaesthetic, which puts you completely to sleep.  Once you have anaesthesia, your surgeon will make sure the skin of your hand is free of infection by cleaning the skin with a germ killing solution. 

An incision is made across the base of the thumb. The soft tissues are spread apart with a retractor. Special care is taken not to damage the nearby nerves going to the thumb. The joint capsule is opened, exposing the CMC joint. The ends of the bones that form the CMC joint surfaces are taken off, forming flat surfaces. A burr (a small cutting tool) is used to make a canal into the bones that form the thumb joint. The surgeon sizes the stem of the prosthesis to ensure a snug fit into the canal and inserts it. When the new joint is in place, the surgeon wraps the joint with a strip of nearby tendon. This gives the new implant some added protection and stability. The skin is stitched together. 


After Surgery

After surgery, your thumb will be bandaged with a well-padded dressing and a splint for support. The splint will keep the thumb in a natural position during healing.   The splint will be kept on for up to six weeks.  Stitches will be removed after ten to fourteen days, though most of your stitches will be absorbed into your body. You will be seen by your surgeon in clinic at six weeks post operation.

You may have some discomfort after surgery. You will be given pain medicine to control the discomfort.  You should keep your hand elevated above the level of your heart for several days to avoid swelling and throbbing.  Keep it propped up on a stack of pillows when sleeping or sitting up.

You will see a hand physiotherapist at three weeks post operation who will direct your recovery program. You will begin gentle range-of-motion exercise. Strengthening exercises are used to give added stability around the thumb joint. You will learn ways to grip and support items in order to do your tasks safely and with the least amount of stress on your thumb joint. As with any surgery, you need to avoid doing too much, too quickly.