Nasser Hyder - Orthopaedic Hand, Wrist and Trauma Surgeon Your Practice Online
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After Care and Therapy

Excision of Trapezium

Excision of trapezium is commonly performed for arthritis affecting the joint at the base of thumb. This requires either a general anaesthesia (being asleep) or regional nerve block (when only the limb is numbed or frozen). Unless there are medical reasons to stay overnight, patients are discharged on the same day with advice and some pain killers.

0 - 2 Weeks

You will be sent home with a short plaster cast holding the thumb in a comfortable position. The bandage will extend up to the knuckles of the fingers but the thumb will be bandaged with plaster. This is done to minimise pain after the operation. The bandage should not be disturbed for two weeks.

2 - 6 Weeks

You will be attending the OT (Occupational Therapy) at two weeks. The plaster and bandage will be removed by the therapist and skin stitches will be removed. The scar may still look very fresh with scabs and this is normal. You can wash your hands but keep it clean and dry in between washes. A removable thumb splint will be provided to you, which you will have to wear for the next 4 weeks.

Exercises and Stretches

You will be given instruction regarding exercises and stretches by the therapist. You will be asked to move the thumb towards other fingers and in reverse direction several times during the exercise sessions. Stretches will be performed by the therapist.

In between the sessions, thumb splint will be worn to keep pain in control.

Gradually more strengthening exercise will be performed using resistance and some force.

Scar Management

Scar is often tender and sensitive for a while and massaging it with a cream (E45) helps. In severe cases silicon gel is used. The scar will gradually settle down and fade. This could take between 3 to 6 months.

After 6 Weeks

Your first clinic appointment is at 6 weeks from operation. You will be advised to discontinue the use of splint and try to return to normal activities. The scar may still be a little tender. The strength in the thumb also is reduced at this stage but with exercises and normal use, it continues to improve for the next 12 months.

 

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Hand & Wrist Elbow After Care and Therapy