After Care and Therapy
Fusion of CMC (Thumb) Joint
Fusion of CMC joint of the thumb is performed for arthritis affecting the joint at the base of thumb. This operation 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 in hospital, patients are discharged on the same day with advice and some pain killers.
0 - 2 Weeks
You will be sent home with a plaster cast holding the thumb in a comfortable position. The bandage will extend from forearm up to the knuckles of the fingers but the thumb will be bandaged with plaster. This is done to protect the newly performed fusion and to minimise pain after the operation. The plaster should not be disturbed until you are seen in the clinic 2 weeks later.
2 - 6 Weeks
You will be seen in clinic at about 2 weeks. The plaster will be changed and the skin stitches will be removed. An x-ray of the thumb will be performed. A new plaster will be applied to protect the fusion of the joint till it heals (6 to 12 weeks). The plaster will extend from the middle of forearm up to the knuckles of fingers and the last joint of the thumb. You should exercise the fingers regularly.
6 - 12 Weeks
You will be seen again at 6 weeks and the plaster will be removed. A fresh x-ray will be performed to look for signs of healing. It may be necessary to use a removable splint for a further 6 weeks to protect the thumb. You may be referred to therapy for exercises of wrist and fingers.
Exercises and Stretches
The therapist will instruct you regarding exercises and stretches. You will be asked to move the thumb towards other fingers and in reverse direction several times during the exercise sessions. In between the sessions, thumb splint may be worn. You will be taken through a graded strengthening exercise programme.
Scar is often tender and sensitive for a while and massaging it with a cream (E45) helps. In severe cases silicon gel may be used. The scar will gradually settle down and fade. This could take between 3 to 6 months.
After 12 Weeks
You will be seen again for a follow up in the clinic and a new x-ray will be carried out.
If the joint has healed (fused) then this will be your last appointment. You can now discontinue the use of splint and will be advised to return to normal activities. The thumb may still have reduced strength but with use and exercise, it will continue to improve for the next 12 months.