GENERAL GUIDELINE 3 months Night splint discontinued. 0-48 hours Joints can continue to settle for 6 Keep hand elevated to minimise months+ post op. swelling. Return to work will depend upon what 0-2 weeks job you do—check this with your In plaster cast, do gentle exercises surgeon. hourly. 2-6 weeks New exercises shown in COMPLICATIONS OF SURGERY physiotherapy. Cast should be worn at all times Occasionally complications can occur, except hand washing and these are: TRAPEZIECTOMY exercises. Infection Hand at this stage should not be Radial nerve hypersensitivity WITH used for lifting or gripping. Medium nerve complications Complex regional pain disorder SLING PROCEDURE 6-8 weeks Excessive swelling Wean off splint during day and use hand for light activities. If you require this leaflet in any Avoid activities that cause pain. Continue to wear splint at night other format, e.g. large print, at this stage until 3 months post op. Light pinch grip and gripping please phone exercises begin. 01935 384256 8-10 weeks Gentle strengthening continued. Resume driving. Contact Numbers Physiotherapy Department 10-12 weeks 01935 384358 Hand Therapy Normal use of hand may be Service resumed if the joint is stable. Occupational Therapy Department 01935 384215 www.yeovilhospital.nhs.uk Leaflet 14024010 11/10 Review Date Nov 2012 WHY THIS OPERATION HAS BEEN INFECTION RECOMMENDED FOR YOU 1st Metacarpal Please report any signs of infection At the base of the thumb is a small bone base quickly, these include: called the trapezium which, together with Increase in pain not related to the metacarpal bone above, forms a joint exercise called the carpometacarpal joint (CMC). Increased swelling Pain in the arm Arthritic changes caused by ‘Flu’ type symptoms combined with degeneration (wear and tear), trauma Trapezium any of the above or rheumatoid arthritis can affect this joint and cause pain on use of the thumb EXERCISES AT THIS STAGE ARE in daily activities. Try to do these exercises hourly: Reconstruction of this joint will help to AFTER THE OPERATION 1. Bend and straighten fingers gently reduce the pain and make it easier to (10 times). use the thumb. Your hand and wrist will be in a plaster 2. Bend and straighten tip of thumb, cast for 10-14 days initially. You will be if able (10 times). ON THE WARD offered mild pain relief medication for the 3. Bend and straighten elbow first few days to help with any discomfort (10 times). You will be visited by the doctor, which you may have. Severe continuous pain 4. Lift arm up above the head and will give you a chance to ask any should be reported to your doctor. down again (10 times). questions you may have. SWELLING CLINIC REVIEW THE OPERATION To minimise swelling, it is important to At around two weeks you will be The trapezium bone is removed and the keep the hand elevated. reviewed in clinic, your stitches will be base of the 1st metacarpal is trimmed. 1. Use the sling provided to keep your removed and a new, removable cast, will A soft tissue spacer is made from part hand above your heart for the first be made. of a tendon taken from your wrist and 48 hours after surgery. put into this space, this is tied to the 2. Remove your sling hourly so you This cast should only be removed for base can do the exercises described in exercises and hand washing as the of the first metacarpal and rolled as a the next section. reconstruction is still healing. spacer, the joint capsule is then closed. 3. When lying or sitting, support your Overstretching at this stage may affect hand on pillows at heart height. the stability of your thumb. The cast An alternative operation is that the 4. If you experience excessive should be worn day and night. trapezium bone is removed and the swelling and the plaster becomes capsule closed. too tight, please contact the Plaster You will be referred to physiotherapy for further exercises. .