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) (see figure 1).

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.

A steroid injection into the joint can reduce pain in most people.

It is possible to replace the joint with an artificial joint made of metal and plastic.

For young and active people, it may be better to have an arthrodesis (where the thumb bones are permanently fixed together using screws).

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.

1 General complications of any operation

  • Pain
  • Bleeding
  • Infection of the surgical site (wound)
  • Unsightly scarring

2 Specific complications of this operation

  • Continued numbness or pain
  • Damage to the artery that passes near to the trapezium
  • Severe pain, stiffness and loss of use of your hand (complex regional pain syndrome)

How soon will I recover?

You should be able to go home the same day.

Keep your hand raised for two weeks.

The bandage or plaster cast will be removed after four to six weeks. It is important to gently exercise your thumb and fingers to help you to recover. Gently exercise your elbow and shoulder to prevent stiffness.

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.

Acknowledgements

Author: Prof Tim Davis ChM FRCS (Tr. & Orth.)

Illustrations: 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 that your relevant health professional would give you.

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