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).

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 but you may find that a splint makes it difficult for you to perform normal activities.

A steroid injection into the joint can reduce pain in most people but the symptoms usually come back after several weeks or months.

It is possible to replace the joint with an artificial joint made of metal and plastic but most thumb joint replacements have a high failure rate and can also cause pain.

For young and active people with no arthritis below the trapezium, 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.

How can I prepare myself for the operation?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

General complications of any operation

• bleeding
• infection of the surgical site (wound)
• allergic reaction to the equipment, materials or medication
• chest infection

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
• failure of the operation to improve your symptoms

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day.

Keep your hand raised for 2 weeks.

Speak to your surgeon about when your bandage or cast can be taken off.

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.

IMPORTANT INFORMATION

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