Dr. Alexandra Turner Plastic Surgeon MBBS BSc FRACS MED00001125632

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Hand Surgery Adelaide - Carpal tunnel release cubital, trigger finger, trapeziectomy, Dupuytren’s, finger joint replacement

Trapeziectomy with Ligament Reconstruction

A trapeziectomy with ligament reconstruction is a surgical procedure commonly used to manage symptoms and functional limitations caused by advanced osteoarthritis of the thumb (basal) joint. This operation may be considered when non-surgical treatments no longer provide adequate relief.

What is Osteoarthritis of the Thumb Joint?

Osteoarthritis in the basal thumb joint is a painful and frustrating condition. It occurs between the thumb metacarpal and the trapezium, a small bone in the wrist. This joint is essential to maintain a large range of motion in the thumb.

Osteoarthritis in the joint at the base of your thumb is very common. It can be very painful and prevent you from performing simple daily activities.

Reasons to Consider a Trapeziectomy and Ligament Reconstruction

Sufferers of arthritis in the thumb often experience pain related to certain activities, including pinching and gripping movements like peeling vegetables and opening packets. As arthritis progresses and joint degradation continues, noticeable swelling around the joint may occur. If left untreated, it can lead to pain even at rest and potential deformity at the base of the thumb (a crooked-looking thumb).

A trapeziectomy may help relieve pain and improve hand function for individuals experiencing symptoms related to osteoarthritis of the thumb. This procedure is typically considered when other non-surgical options have not provided sufficient relief.

Trapeziectomy with Ligament Reconstruction procedure

During the trapeziectomy, the surgeon will remove the arthritis affected bone (trapezium) and then reconstruct the ligaments to stabilise the joint.

The surgery involves an incision at the base of the thumb and the complete removal of the trapezium bone. The surgeon will then stabilise the thumb with supporting structures.

The trapeziectomy and ligament procedure is performed as day surgery under general anaesthesia, and you will likely return home the same day. Your wounds will be covered with surgical tape, and a plaster splint or a supportive hand and wrist dressing applied.

Potential Risks and Complications 

Modern surgery for trapeziectomy with ligament reconstruction is generally safe, but it has the potential for risks and complications. These complications can include wound healing problems, infection, bleeding, bruising, stiffness, weakness, nerve injury, or slower-than-expected recovery. Temporary or permanent changes in sensation of small patches of skin over the back of the thumb or back of the hand may occur. Another procedure may be required in the future.

Recovery after surgery

We will give you guidelines to ensure the best recovery possible following your surgery. Recovery times vary from patient to patient, but most people recover from the operation within six to eight weeks and regain their full hand strength and movement within six months.

In the week following your procedure, the plaster splint will be replaced with a removable splint custom-made for your hand.

After the first week, the splint may be removed for hygiene and gentle exercises if your hand feels comfortable. You will work with a hand therapist to rehabilitate the movement and strength in your hand and thumb.

In most cases, you can stop wearing the splint after four to six weeks, and you can gradually return to regular use as your hand allows. In some cases, the area around the base of the thumb remains swollen for a few months after surgery; gentle massage and moisturising the area can help.

 

Call Dr Turner’s office today to book your appointment to find out how to relieve the pain of arthritis in the thumb joint with a trapeziectomy.