Advice after your nerve block for surgery
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What is a Trapeziectomy?
Trapeziectomy is a common surgery that involves removing of the trapezium bone at the base of the thumb. Removal of this bone gives more space for the thumb to move and reduces the bone surfaces from rubbing together which cause pain.
Some Surgeons fill the space with a piece of rolled up tendon, usually harvested from the same wrist; others prefer to simply leave a space, allowing for it to naturally stabilise with scar tissue.
What are the benefits of the operation?
The main reason for the operation is to relieve pain and stiffness caused by arthritis at the base of the thumb.
The first and most important gain is pain relief. The second gain is improvement of the movement of the thumb and improved overall hand function.
What are the potential risks involved?
The majority of people have straightforward recovery following surgery. However, complications can occur and include:
• Infection
• Nerve damage causing change in sensation or loss of feeling in the thumb area
• Ongoing scar tenderness
• Injury to the arteries of the finger or hand
• Failure to resolve the pain
Are there alternatives to having surgery?
Rest, splinting, exercise, pain relief and steroid injections into the joint may improve symptoms. These are usually tried before the option of surgery is considered.
What does the operation involve?
The trapezium bone is removed through a small incision at the base of the thumb. Sometimes a temporary wire is placed across the joint to stabilise it if it has been overstretched.
What happens before the surgery?
You will be referred to a hand therapist who will carry out an assessment to determine your baseline measurements and hand function.
You will be asked to complete a questionnaire about your hand function which your therapist will use to compare your surgical outcome to.
What happens after the surgery?
Your thumb and hand will be put in a cast for the first 4 weeks.
If a wire has been inserted, this can be removed after 3 to 4 weeks.
While your cast is on, it is important to:
- Regularly raise your arm above your head to help get rid of swelling
- Keep your fingers moving fully to prevent them from becoming stiff
- Do not use your hand for anything other than very light activities (e.g., using a telephone, finger typing, turning on a switch)
- Do not drive
You will be given the number of the Plaster Room 0300 615 4058 to book an appointment 10-14 days post op. This will be with the Plaster Room to do a dressing change and to change the cast to a full plaster. At 4 weeks, you will see the Plaster Room again to remove the cast, and you will see a hand therapist immediately after this. The hand therapist will provide you with an appropriate splint, start exercises and continue to and see you for your rehabilitation.
How long will I be in hospital?
The surgery is generally a day procedure, which means you can usually go home on the same day as your surgery. Depending on the procedure, it may be performed under local anaesthetic, in which you will remain awake; or under general anaesthetic, in which case you will be asleep.
When will I be able to drive again?
You can return to driving when your cast or splint has been fully removed (usually between 8 and 12 weeks after your operation) and it is comfortable and safe for you to do so. You must feel that you are in complete control of the car; it is your responsibility to check with your insurance company before returning to driving.
When can I return to work?
This will depend on your occupation, place of work, ability to return to light duties and may at times be dependent on whether the operation has been carried out on your dominant hand or not.
Please remember that recovery of full function can take a long time, in some cases it can be 6 months or more before you can carry out heavy functional tasks.
Contact us
If you have any queries relating to this information, please contact the Plastic surgery service.
About this information
Service:
Plastic surgery
Reference:
T/031
Approval date:
8 August 2024
Review date:
1 May 2026
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.