Trapeziectomy

[Ex contributorParticipant @mgnbuk]

Has anyone on here had one (or both) done ?

Looking to find out from someone who has undergone the procedure whether or not it was worthwhile, were there complications, was the recovery & rehabilitation period as long as is suggested, was there loss of mobility or function when recovery was deemed complete, was the pain relieved and, finally, would you choose to have it done again with the benefit of hindsight ?

I have an appointment with a consulant if a couple of weeks & am pretty sure that this is the only way forward that will be proposed – a steroid injection in October has made things worse, so I won't be looking to have any more of those.

Nigel B.

( I have intentionally not described the procedure – those who have had it done would know about it ! ).

[Ex contributorParticipant @mgnbuk]

[Brian Sweeting 2Participant @briansweeting2]

Hi Nigel

Not me but my wife has had both hands done, not at the same time I must add.

She had been having injections for some time but they were getting less effective. Don't know if it has been offered to you but she had the procedures done under local anesthesia and would highly recommend that method. The recovery time was greatly improved and recovery was also reasonably painfree, she was sent home with painkillers but only used paracetamol to subdue it.

The hand exercises post-op were soon mastered and apart from some loss of strength overall she is 100% better and glad that she had it done.

The only downside from my point of view is that she didn't think it wise to take the vacuum cleaner duties back after her recovery.

 

Edited By Brian Sweeting on 29/01/2020 16:08:03

[Neil WyattModerator @neilwyatt]

I'll be interested to know more,I have arthritis in the base of my thumbs, especially the left.

Neil.

[Simon CollierParticipant @simoncollier74340]

Same, Neil. Thumbs have always been hypermobile, pretty much guaranteeing later arthritis. Most unhelpful in the workshop.

[Ex contributorParticipant @mgnbuk]

Brian,

Thanks for that – it is encouraging to have a positive report. Out of interest, how long did the rehab take ? The consultant told me (while administering the steroid injection) that it would take "around 6 months until you regain control of the thumb" & the online descriptions of the procedure all sing from a similar hymn sheet (6-12 months recovery period). From the post-operative timeline quoted, I could see why both hands would not be done at the same time.

Neil,

Yes, it is arthritis at the base of my thumbs that is my problem also, though my right is the worse (right handed).

Just mechanical wear through nearly 60 years of use. In my case, there really isn't much of a joint to talk about. The trapezoid bone is the wrist contact point of the first thumb bone & has a "cup" that the "ball" of thumb bone sits in. Roughly half of both the cup and the ball are worn away & the two bits just rub together rather than act as a bearing. Having seen the X-ray, I can see now why I struggle to get motorcycle gloves to fit – I always though they were made with the thumbs too long, but is apparent that it is my thumbs which are 5-10mm shorter than they should be !

The trapeziectomy procedure is the removal of the trapezoid bone, which is not replaced. The thumb bone end is supported on scar tissue alone & there is no longer a bearing as such. With nothing to rub against, the pain is supposed to be eliminated, but grip is said to be lower (though apparently better than pre-op, due to lack of pain). The quoted recovery period is 6-12 months which, as I am still working, is a long time to take out.

The consultant did mention replacement joint parts, but then said that they would not stand up to serious usage & were suitable mainly for "little old ladies who do nothing more arduous than lift a tea cup". I have seen reports online of sucessful fitting of 3D printed replacement first thumb bones to people who have lost that bone due to cancer, but such items are probably not yet available on the NHS.

The steroid injection has made things a lot worse. It was never guaranteed to have any effect, but I wasn't expecting it to have made matters worse. Due to the lack of any joint gap to inject into, my thumb had to be forcibly pulled apart & the injection made under X-ray so that the consulant could place the steroid correctly. It feels to me that the bones have not gone back to where they were, but it will take another X-ray to see if that is the case.

All part of wearing out, I suppose !

Nigel B.

[Bill Davies 2Participant @billdavies2]

I've also got rheumatism in the left thumb, it now clicks! I'm right handed, so would have expected that one to wear out first. Painful at certain positions, most painful removing a glove!? A colleague had steroid injections, which she said helped. I expect I will need that, so Nigel's comment is of interest or concern.

Bill

[Brian Sweeting 2Participant @briansweeting2]

Sorry Nigel, I forgot to read back on this thread.

Just checked with my wife and with the first op she was back at work (office receptionist, paperwork, data entry, phones etc) after 6 weeks with driving a few weeks later.

The second she wasn't working but was carer for my mother and she was back driving etc after 6 weeks.

The exercises involved squeezing on a rubber type ball to strengthen things and touching each fingertip with the tip of the thumb. Like all recuperation you get back what you put in.

Not sure if this makes a difference but she had her carpal tunnels done some years prior to this work.

Edited By Brian Sweeting on 01/02/2020 16:07:14

[Ex contributorParticipant @mgnbuk]

Thanks Brian.

That is a lot quicker than I was expecting. I have had both carpal tunnels done in the past as well – right hand when I was 30 & left hand when I was 40.

Nigel B.

[Brian Sweeting 2Participant @briansweeting2]

If I remember rightly the thumb to fingertip exercise had a progressive visual result, if you start with thumb/index finger then when you can reach to your little finger you are almost there.

Good luck with it all, I'm sure things will be great, I know her lack of pain was a bonus for both of us

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