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Surgery can last up to 90 minutes. Surgery is done using a general anesthetic, which puts you completely to sleep. Once you have anesthesia, 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 will be made that angles along the back of the thumb to the edge of the wrist. Special care is taken not to damage the nearby nerve going to the thumb.  The CMC joint and surrounding tissues are exposed. Next, the joint capsule surrounding the CMC joint is opened. The surgeon takes out (excises) the trapezium bone at the base of the thumb.Then the he removes a small section of one of the tendons near the thumb. The piece of tendon is sewn into a small ball and placed into the space where the trapezium bone was removed. The remaining portion of the tendon is sewn to the thumb metacarpal to stabilise the joint. The surgeon may also insert a surgical pin to connect and hold the metacarpal bones of the thumb and index finger.  The pin protects the reconstructed joint and is usually removed three weeks after the surgery. The soft tissues over the joint are sewn back together.  

 

After Surgery

After surgery, your thumb will be bandaged and placed in a POP splint for support. The splint will keep the thumb in a natural position during healing. The POP splint will be removed after one week and replaced with a thermoplastic splint.  You will be immobilised for six weeks. 

Your surgeon will want to check your hand within five to seven days. Stitches will be removed after ten to fourteen days, though most of your stitches will be absorbed into your body.

If a surgical pin was used, it will be removed three weeks after surgery.

You may have some discomfort after a trapeziectomy but 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 wear your thermoplastic spline for six weeks to give the repair time to heal. You will then be seen by a physiotherapist  who will direct your recovery programme. You will likely need to attend therapy sessions for one to two months, and you should expect full recovery to take up to four months.  The first few therapy treatments will focus on controlling the pain and swelling from surgery.   You will then begin gentle range-of-motion exercise. Strengthening exercises are used to give added stability around the thumb joint.