The procedure | Painful base of thumb

In many people the base of the thumb becomes painful over time. The most common cause is wear and tear of the joint due to increased instability (CMC1 joint). It occurs more often in women than in men. In case of severe damage to the joint surfaces, treatment is to remove a small bone in the wrist (Trapezium) followed by stabilising of the joint.

Where will I be operated?

If an operation is the best option in your case, then this will be performed in the fully equipped operating theatre at the Radetzky villa.

What can I expect of the operation?

The operation will be performed under regional anaesthetic and will take approximately 60 minutes. Your surgeon will always see you before the operation and will talk you through the steps. The procedure will start by numbing the skin of your arm. This is followed by prepping and draping of your lower arm and hand. Markings will be made and your arm will be elevated in order to reduce the amount of blood inside. Then a band around your upper arm will inflate tightly to prevent blood from running through your arm for the period of the operation. Your surgeon will use a precise electric devise to stop any bleeding that may occur and will use a suture to close the wound.

What are the risks?

The treatment of a painful base of the thumb is considered to be a low risk procedure. The most common complications are postoperative bleeding, infection or scar reactions. In some cases this may lead to prolonged recovery. Luckily these complications only seldom occur.

What can I expect after the operation?

In the first 24 hours regular elevation – with your hand being higher than the elbow – is wise. When the anaesthetic wears off you may experience some slight discomfort. Your hand and thumb will need to be stabilised for a prolonged period. The first 4 weeks you will be in a cast, followed by another two weeks with a splint. During this period a hand therapist will supervise your recovery, and will do exercises with you to ensure a swift return of function.

What will the scar be like?

The scar will be limited and will run along the base of your thumb. It will be slightly red for the first few months. Eventually the colour will even out. Typically a scar will take one year to fully mature and in the majority of cases the scar, although present, should not be on the foreground anymore by that time.

How long before I can resume my normal life?

Stabilising the joint is an important aspect of this procedure. The cast will help with that, but will obviously restrict your movements in the first 4 weeks.

What is good to know about the long term?

Removing this small bone is a good way of reducing the pain, but may result in a slight reduction in strength. At the time of consultation your surgeon will be able to elaborate on the effect this might have in your specific situation.
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