Health All about... trapeziectomy We look at problems with the thumb and the surgery thatmay help Words: Dr Sarah Jarvis Y our trapezium is nothing to do with being a high-flying acrobat although youd have problems swinging between trapezes without the pair you own. Your trapezium is actually a small cube-shaped bone at the base of your thumb. The thumb contains two bones (phalanges); each of these is attached at thebase to a metacarpal bone, which, inturn, is attached to a carpal bone, close to your wrist. Your trapezium is one of your carpal bones. Arthritis can cause problems with almost any joint in the body, and the hand joints are among the most frequently affected. Although your thumb is only one of five digits in the hand, it does almost half the work of the hand. That means its almost constantly in use, and arthritis at the base of the thumb is common. Thecartilage that covers the ends of the bone becomes worn away, exposing the bony surface underneath. The result is pain, stiffness and decreased mobility. Having a trapeziectomy If painkillers or splinting dont control your pain, your surgeon may recommend removing For more the trapezium bone, in a procedure known as a trapeziectomy. information, see The operation can be done under general or regional anaesthetic with the latter, Arthritis Cares youre stillawake, but your anaesthetist numbs all the nerves in your arm. Itinvolves a small trapeziectomy factsheet cut at the base of your thumb, at the back, to remove thebone, and sometimes making a go to arthritiscare.org.uk/ newligament to connect your thumb toyour wrist. do-i-have-arthritis/ After surgery, you may be allowed home the same day, but you wont be able to drive for publications/1636six to 12 weeks, so youllneed to make arrangements to be taken home. You also wont be able trapeziectomy to use your hand for a couple of weeks, and your thumb for several weeks. Its very important to keep your hand raisedas much as possible for at least the first two days above the level of your heart, even when youre walking, toreduce swelling. Youll be in a plaster cast or have a bulky dressing for at least the first two weeks after your trapeziectomy. After this, your stitches or staples will be removed and you may be given a lighter splint, which will allow you to start exercising your thumb gently under instructions from your physiotherapist. The splint may be removable, but to begin with you should keep it on all the time, except when youre exercising or washing your hands. It will need to stay on for up to six weeks. Trapeziectomy isnt for everyone: it can take six months to regain full function, and you may not have the same strength in your thumb. This clearly isnt ideal if your job involves heavy lifting. As with any surgery, there is also a risk of complications, including infection, scarring, continued pain, and numbness or pain because of nerve damage. However, the aim of the procedure is to reduce pain, and it does this effectively for most people.