Trapeziectomy

This is a surgical procedure to remove a small bone at the base of the thumb. The bone forms one of the carpal bones and can become affected by arthritis. When disease severity interferes with function and pain can not be controlled by less invasive alternatives, one option is removal of the affected bone.

This is often accompanied with a soft tissue procedure to ensure that the thumb remains in the optimum position for function. The procedure can be performed as a day case under a regional block anaesthetic (arm block). It does not require a general anaesthetic.

Following the procedure the thumb is initially immobilised in a plaster splint which is exchanged at 2 weeks following surgery for a soft neoprene thumb wrap. Gentle hand therapy is essential in the postoperative period to maximise hand recovery.

This procedure can cause discomfort in the early postoperative period but oral pain killers are usually sufficient to control the symptoms after the arm block has worn off.

The procedure results in a scar about 4 to 5cm in length at the base of the thumb. This scar frequently settles down well. Occasionally patients can experience slightly altered sensation on the back of the thumb and sometimes the hand itself, if one of the smaller branches of a sensory nerve in that area becomes irritable.

Wound infections and bleeding are uncommon. It usually takes a few months for the hand to recover fully. The operations aims to reduce pain at the base of the thumb however the trade off is a slightly weaker grip strength.