It is mandatory if the joints both above and below the trapezium are arthritic. ¤º ×U F.Wear splint at all times except washing and excercises • … Depending on the procedure Elevate your hand as much as possible, as having your hand dangling down will cause swelling and make your hand more uncomfortable. Current approaches to trapeziectomy use Kirschner wire fixation to prevent subsidence. A cast is then placed with first MC in palmar abduction, MP in ~10-20 degrees flexion, wrist neutral, IP free. If your thumbs develop arthritis then you may find gripping and pinching objects progressively painful. Trapeziectomy which means removal of the trapezium. ",#(7),01444'9=82. Not too long ago, these patients would have been casted for 4-6 weeks and been extremely stiff afterwards, with long recoveries likely. but if they are not effective surgery may be an option. It is a progressive condition that leads to increasing stiffness and deformity in the thumb. Postoperative Rehabilitation Following Trapeziectomy and Ligament Reconstruction Tendon Interposition (LRTI) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. This is usually combined with reconstruction of the ligaments. POST-OP WEEKS 1 & 2 • In general, post-operative follow-up occurs during this week, the sutures and bulky dressing will be removed • Concentrating on regaining full range of motion of the second through fourth digits is a must • A post-operative thumb spica splint or cast will be applied to the area and is to be worn for 4-6 weeks Trapeziectomy with ligament reconstruction is performed routinely by many surgeons.  Avoid activities that cause pain. B.Modify if MP joint capsulodesis or fusion. Restrictions: No heavy lifting greater than 2 lbs. A.Pin removed if needed (rarely use pin). Trapeziectomy is a type of hand surgery used to treat arthritis of the lower end of the thumb. The most . Potential benefits of the operation include improved thumb … The post-surgical procedures, however, are much lengthier. A new cast will be applied. This is a step-by-step guide to the technique of trapeziectomy along with suspensionplasty using the tendon of the Abductor Pollicis Longus (APL). This is usually 6-12 weeks after surgery. The main benefit of surgery is to relieve pain and so improve how your thumb works. • After surgery, you will be in a bulky dressing (bandage) with a plaster splintthat covers your thumb, wrist and forearm. There is Postoperative Guidelines. Patients with advanced disease or who fail non-surgical treatment may be candidates for surgical reconstruction. It is half plaster to allow swelling. This is likely the most common post-surgical diagnosis I see, especially with the winters we have here in Minnesota. A.Start ROM, make removal thumb spica splint. A post operative dressing is placed until the MD follow-up appointment, usually within 1 week of surgery. When hand therapy begins, a removable splint is applied. You can return to work when you feel that you have enough strength and control to carry out your job. éBè̓ÖU(…Ðõ‚+1†•ékÒk椠³LlÓ~Ù¶ÓÉÍëÈÃ>­khN(Œ$’‚ÁMÒÉ!¢Iâ’Å©BÈo@ž("ȀèF[ý¤N¤N§ÔwPE‡ÿx‘× The splint is similar to a cast. endobj Due to the advancements in surgical techniques, we are now mobilizing distal radius ORIF’s 3-5 days after surgery. The thumb is then put in a complete cast for another 2 weeks before physiotherapy commences. Menu Healthdirect Free Australian health advice you can count on. Scar massage with lotion, scar retraction using a piece of dycem, and use of a scar remodeling product such as Rolyan 50/501M, OtoformK™, or Elastomerm are recommended. The splint can not be removed and must be kept dry. Afterward, the patient may be required to … 2016 Jun;11(2):232-7. doi: 10.1177/1558944715616955. The operation is about 90% successful. 5 0 obj Trapeziectomy involves the complete removal of the trapezium bone. Trapeziumectomy is removing the trapezium bone (the one that sits under the thumb and is affected by arthritis) and reconstructing the thumb with a tendon transfer (a piece of tendon that comes from the front of the wrist, which we get through two small incisions). (Thumb must NOT be positioned in radial … The usual indication is pain and consequent functional difficulties. ÿØÿà JFIF ` ` ÿÛ C After the Surgery. A trapeziectomy can relieve the pain and so improve how your thumb works. Some surgeons fill the gap but there is no evidence that this improves outcome. Following a period of 2 weeks in plaster cast and 4 weeks in a removable splint and hand therapy the patient is expected to be much more comfortable using their hand however the pain reduction and strengthening often continue to improve up to 6 months post-procedure. A variety of surgical techniques are available that can successfully reduce or eliminate pain. 7-10 day post-op • OT to fabricate a custom FA based thumb spica • AROM of the wrist and thumb • Scar massage 4 weeks post op • PROM for the thumb and wrist • Cut orthosis down to a hand based thumb spica 6-8 weeks post op Arthritis Care • Trapeziectomy 3 If you drive You can return to driving when you feel you can control the vehicle safely. Patients are commonly off work for 1 week, and then on light duty for 2-3 months. However, as in any surgery, comlpcations can occur. Some of these cookies are essential to make our site work and have already been set. Normal activity with the hand usually starts about 3-4 months after surgery. Base of thumb arthritis - Trapeziectomy & suspension arthroplasty.  Wean off splint during day and use hand for light activities. Trapeziectomy and CMC Arthroplasty Download PDF. LRTI surgery removes a small bone (trapezium) at the base of the thumb, and rearranges a nearby tendon to serve as a cushion for the arthritic thumb joint. ). I.Thumb Spica cast for 4 weeks. 12 to 14 days post-operation You will have an appointment at the hospital. This particular technique is simpler than other ligament reconstructions following trapeziectomy, as it obviates the need for creating cumbersome bone tunnels and can be done through a single incision I was kept fully informed and felt it was me making the choices. which is removal of the bone at the bottom of the thumb, which forms one surface of the arthritic joint.. You will see the hand therapist to replace the plaster or dressings with a plastic, removable splint custom made to your hand. Arthritis in this joint is very common and is contributed to by instability of the joint and a natural vulnerability to wearing of the joint surfaces. It is an outpatient procedure that can be performed under regional or general anesthesia and requires significant rehabilitation to maximize the function of the hand. E.Active MP & IP joint motion while supporting metacarpal. Protocol W4 – Physical or Occupational Therapy Protocol for Trapeziectomy and Suspension-Interposition Arthroplasty w/Tendon Autograft Phase I – Protection Phase (weeks 0-6) Phase II – Motion Phase (weeks 7-12)