What Are the Pros and Cons of a Trapeziectomy?
- Written By: H. Colledge
- Edited By: Heather Bailey
- Last Modified Date: 09 May 2013
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2003-2013 Conjecture Corporation
Trapeziectomy is a type of hand surgery used to treat arthritis of the lower end of the thumb. The procedure involves the removal of a bone called the trapezium, which forms the thumb's base. Potential benefits of the operation include improved thumb function and relief from stiffness and pain. Possible negative effects, while uncommon, can include infection, loss of skin sensation and, very rarely, chronic regional pain syndrome, where the hand become severely painful and swollen. Recovering from the surgery takes time, and it could be three to six months before strenuous activities are possible.
The kind of thumb arthritis that is treated with this procedure is known as osteoarthritis. Osteoarthritis generally results from gradual wear and tear affecting joint surfaces. As the thumb is used so frequently in daily activities, osteoarthritis of the thumb is a common condition. Symptoms of stiffness and pain are typically experienced, and the thumb may become deformed. The main benefit of a trapeziectomy is that, when other treatments such as painkillers, splints, and steroid injections fail to work, this surgical procedure may provide relief.
In order to carry out a trapeziectomy, a general anesthetic may be required, although a regional anesthetic, which numbs only the arm, may be used. A cut is made near the thumb's base and the trapezium bone is extracted through it. The resulting space in the joint means that damaged bone surfaces are no longer moving against one another.
A drawback of this surgery is that it is not possible to use the hand normally for a while after the operation. Sometimes, the thumb is held in position using a wire, which sticks out through the skin and is typically removed a few weeks following thumb surgery. A plaster dressing is applied to the thumb for the first few weeks while healing takes place. This is then replaced by a splint, which is worn for about six weeks, and hand exercises are generally carried out under the supervision of a physiotherapist. It may be necessary to wear a softer splint later while recovery continues.
While risks associated with trapeziectomies are low, it is possible that the operation site may become infected, requiring treatment with antibiotic medication. Rarely, bleeding may occur under the skin, or nerves may be damaged leading to numb areas of skin developing over the thumb. Chronic regional pain syndrome, also known as complex regional pain syndrome, is an extremely rare complication that can occur following any type of hand surgery. The hand is affected by extreme pain, swelling, and loss of movement, and it can take several months to treat the condition using a combination of painkilling drugs and physiotherapy.
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Discuss this Article
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anon334094
Post 8 |
I'm having this surgery done in June. I am an RN and draw labs from portacaths, PICC lines, and hickman catheters. I also do arm draws for labs. How long before I can go back to my RN duties? |
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golf07
Post 7 |
@John57-- The decision to have a trapeziectomy should be between you and your doctor. If you are at the point where the steroid shots don't help, I think you may want to consider the surgery.
Yes, it takes awhile to recover and there is pain involved with the process, but it is a different kind of pain. Once you work through it, you can get to the point where your thumb doesn't have the constant pain. I have been very happy with mine and love being able to do all the little every day things without pain anymore. |
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John57
Post 6 |
How do you know when it is time to have a trapeziectomy? What started out as a little bit of wrist and thumb pain has turned into pain that never seems to stop.
At first over-the-counter medications would help alleviate the pain, but it got to the point where this didn't work anymore. I have received several steroid injections, but these are only a temporary fix. My thumb is starting to look deformed and isn't straight like it should be.
I am really trying to avoid surgery as I don't want to be out of commission for so long, but I think it is getting to the point where I need more relief. For those of you who have had the surgery, have you had good results? |
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Mykol
Post 5 |
It is amazing how something as small as the thumb joint can cause so much pain and discomfort. I am right handed and the arthritis in my right thumb was the worst. This affected so many things I did like writing, typing, getting dressed, baking, etc.
I finally got tired of fighting it and decided to go ahead with the trapeziectomy. The recovery time was about 4 months before I felt like I had full use of my thumb again, but I sure wish I had the procedure done sooner than I did. |
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andee
Post 4 |
fBoyle-- Doing the exercises and physical therpay after any kind of surgery or injury is always the hardest part! Not only does it take discipline to even do the exercises, but it usually hurts at first which makes it even more difficult. Even though I eventually felt a lot better after my trapeziectomy, it wasn't easy being diligent with the exercises.
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fBoyle
Post 3 |
The worst part about a trapeziectomy surgery is the hand exercises they make you do ten times a day, so boring! I also hated going to the regular appointments with the therapy nurse. |
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donasmrs
Post 2 |
@alisha-- Do you still have your cast on?
I did experience that kind of pain after my surgery but it basically went away once my cast was removed. I think what happens is that the cast can put pressure on the incision area and that makes you feel more pain than you would have otherwise. I think you will be okay once the cast is removed.
I have no complaints about my trapeziectomy. I had severe arthritis and my thumb had become completely stiff. I really couldn't move it and therefore couldn't use my hand before the surgery. Five months after the surgery, it was as if I got a whole new thumb. There is no stiffness nw, no pain, everything is just wonderful. I wish I had gotten the surgery sooner. |
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alisha
Post 1 |
It's been three weeks since my trapeziectomy surgery and I'm still in a lot of pain. The pain started as soon as the anesthesia from the surgery wore out. First it was a dull ache and now it's more of a throbbing pain.
Is this normal?
I know it takes a long time for recovery, but to be honest, I was not expecting pain like this. The surgery went great, everything was easy, post-surgery is a lot harder it seems. |
