What Is a Trapeziectomy?

A splint should be worn following a trapeziectomy.
A patient may be advised to see a therapist following a trapeziectomy to prevent stiffening of the thumb.
The need of trapeziectomy usually stems from cases of osteoarthritis.
Trapeziectomy may require general anesthesia.
A trapeziectomy is a surgery to remove the trapezium bone.
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  • Written By: Felicia Dye
  • Edited By: Heather Bailey
  • Last Modified Date: 18 April 2015
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A trapeziectomy is sometimes classified as a hand surgery. To be more specific, however, this medical procedure involves surgery of the thumb. The trapezium is a small bone at the base of the thumb. The procedure to remove this bone is properly referred to as trapeziectomy.

The need for trapeziectomy usually stems from cases of osteoarthritis. This disease is the result of normal cartilage degeneration. The body’s means to compensate for the loss cartilage in these instances is by promoting bone overgrowth. Instead of correcting the problem, however, a more painful problem is generally created. In addition to the pain, osteoarthritis can limit a person’s ability to perform certain tasks, such as applying a secure enough grip to turn a door handle.

Removing the trapezium provides additional space for the other bones to move. This can result in pain relief because the remaining bones that are arthritic do not have to make contact with another surface. It can also help a person regain abilities that had previously been lost or diminished.

Trapeziectomy is not the only thumb surgery, but it is generally considered to be one of the easiest. Physicians do not, however, tend to employ this surgical procedure as a primary measure. Generally, several pain relief methods have been exhausted before surgery is suggested.

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This is generally an outpatient surgery. The arm is generally numbed with either local anesthesia or general anesthesia. Afterward, the surgeon usually gains access to the trapezium by making an incision at the base of the thumb.

The post-surgical procedures, however, are much lengthier. The dressing and stitching must usually remain on the site for two weeks. Afterward, the patient may be required to wear a splint for six weeks. During this time, the patient is advised to see a therapist and will be taught exercises that she needs to use to prevent the thumb from getting stiff and regain lost abilities. Complete recovery often takes up to six months.

This type of thumb surgery is generally safe. Most of the noted side effects for trapeziectomy are listed as rare. One such side effect is chronic regional pain syndrome. This involves pain, swelling, and sensitivity that are considered abnormal even when considering that a surgical procedure has been performed. In other rare instances nerve damage, which results in numbness, has also been noted to occur.

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anon989487
Post 14

I'm disappointed to read about so many folks having pain after their trapeziectomy. In almost all cases I've read about, it is the choice of surgeon that makes the difference in outcome. I've talked with a number of hand surgeons either face to face, on the phone or in e-mails, and I haven't found one that impressed me sufficiently that they could produce a successful outcome.

Furthermore, the removal of the trapezium in arthritis cases appears to be far to often used to give the patient a short term (less than two years) successful outcome with respect to pain. European hand surgeons have pioneered alternatives to complete removal of the trapezium. They also aggressively treat synovial tissue inflammation and apply

the use of expanded cultured stem cell therapies to provide better outcomes.

Surgeries in development in the US have often passed Europe's equivalent to FDA trials and are used in mainstream medicine in Europe, Japan and elsewhere. I recommend to those considering hand surgery in the USA to talk to two or three well experienced hand therapists and ask them about the doctor you are considering and how many revision surgeries they've seen in their clinic from the doctor in consideration. In my experience, the therapist has not hesitated to quietly let the surgical candidate know which doctors they have seen good work.

anon989325
Post 13

I am a 76 year old male who has had one trapeziectomy five months ago and one seven weeks ago. I had the same surgeon for both. I still have some long term swelling in the first hand, but 70 to 80 percent of the strength and flexibility is back and no pain. I still have some associated nerve problems on the forefinger and thumb on the second and less swelling. Strength and flexibility are returning to the second hand. Different tendons were used.

Sorry, I don't know the names but first was from underside of wrist second from thumb area along side of wrist. I consider both to be successful with the ability to use the hand in a torquing fashion like opening door knobs. Within a year I expect both to be functioning painlessly and normally. Worth the short term inconvenience and pain. Thank goodness for hand surgeons, velcro and elastics!

dmvirago
Post 12

I had this surgery 12 weeks ago today. I'm still going to hand therapy and seeing my second surgeon. I cannot bend my thumb, I cannot straighten my fingers out, the palm of my hand has lumps forming all over it, the joints in my fingers have lumps forming all over them and I'm in pain constantly. They have done tests such as x-rays, MRI and a nuclear scan. They say it isn't infected and that I may have Regional Pain Syndrome and they are sending me to pain management to discuss nerve blocks.

I'm obviously not able to return to work yet. I am fed up and very frustrated. At what point do I seek legal counsel or does someone think I may still recover?

lac
Post 11

I had this surgery 7 months ago. Since coming out of my cast, I have had major swelling in my hand that won't go away. My hand is numb at the surgery site and thumb. I was put on a heavy dose of Prednisone for a month and it did help the swelling but after coming off the Prednisone the swelling came back. My surgeon does not have a clue as to what might be wrong, and his assistant suggested to me that I get another opinion from another doctor. Right now I am at my wits' end. Does anyone have any insight to this problem?

anon326460
Post 9

I had a trapeziectomy. Now my thumb is on top of my palm. I have horrible pain and loss of function Please help and advise.

anon316022
Post 8

I had a trapeziectompy operation nearly four months ago and it's been painful all along. It seems like pain won't go away. I'm sick of pain and painkillers. The operation looks good but pain is incredibly painful. Once the pain goes away, I should be fine, I think.

anon302526
Post 7

I had my first trapeziectomy in 2009, and it was a walk in the park. No swelling or bruising; no problems with anesthesia and I sailed through physical therapy (p/t). I had my other hand done by a different hand specialist (the first one moved out of state).

I had the same anesthesiologist. She followed protocol by asking if I had had trouble in the past with anesthesia. I told her that 1) Once in the past they had a hard time waking me up and 2) Since seeing her last I had lost 60 pounds.

It took longer for them to bring me around enough to be helped to the car and I dry heaved all the way home

and into the night. There is still, after nine days, ugly bruising from my fingertips to my elbow. I still cannot see my knuckles and my splint hurts because of the large bruise on the palm of my hand.

My p/t therapist says it looks like he opened me up and went in with a mower. My first post-surgical appointment is Monday. Wonder how he is going to explain this?

anon294013
Post 6

I had surgery two weeks ago. The outcome is great. I am having some pain, but yes it's expected, but otherwise I'm coming along real good.

burcidi
Post 4

My grandmother had osteoarthritis in her thumb and it had completely deformed it. She hadn't been able to use her thumb properly for the past seven years as far as I know. The doctors tried all sorts of treatments-- injections, splints, physical therapy but it didn't work.

Finally, last year, she decided to go ahead with trapeziectomy surgery. She was in a splint for a couple of months afterward and then received physical therapy. But as soon as she started therapy, she started moving her thumb again.

She can now use her thumb completely! It's quite amazing! She's very happy with the results and we're really happy seeing her do things with her hands that she couldn't do before.

ysmina
Post 3

@feruze-- I'm sorry you're in pain! Unfortunately, it's part of the post-operation and it will slowly go away. From what I remember, I had aching in my thumb for close to two months after my trapeziectomy surgery. But I only had swelling for the first couple of days post-operation. If you have a lot of swelling, there might be something else going on, like an infection, so you should get that checked out.

Also, if you have throbbing pain (rather than aching) it could be because the dressing is too tight. When the dressing is cutting off circulation to your thumb, you will have throbbing pain, flushing and redness in the area. If that's the case, the dressing has to be removed and replaced more loosely.

Once you get your stitches and the dressing removed, I'm sure you will feel a lot better. And it will be easier to check how your thumb is doing too.

bear78
Post 2

Does anyone know how long thumb pain, soreness and swelling will usually last after a trapeziectomy?

It's been three weeks since I had my surgery but I'm still in pain. I can't quite tell how swollen my thumb is because of the dressing, but there appears to be some swelling.

I know that these symptoms are to be expected, but since it's been three weeks already, I'm not sure if this is out of the ordinary or not. I don't want to make a trip to my doctor's office as I'll be heading in to have the stitches removed soon anyway.

I just can't wait for this ache to go away and my thumb to be functional again! I live alone and it's quite a challenge to do anything with my right hand since my thumb is in a splint. And the pain makes it even harder.

milagros
Post 1

This is a relatively recent surgery, replacing of the thumb joint. Its beginnings were rooted somewhere in the 1980's, so this surgery is stil in development.

Very often the surgery is not life lasting. It might have to be repeated after a number of years.

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