Trapeziectomy Post Operative Experience

Etta

I had a Trapeziectomy seven and a half weeks ago. On the removal of the plaster cast it became evident that I could not bend my thumb. I went into a thermoplastic splint immediately after the plaster cast was taken off which I wore until last week and as directed I still wear it at night. I have now been given a soft thumb and wrist support to wear during the day which I have been told to take off for light activities which are listed on an information sheet . Despite regularly trying to do the exercises I was given most are unachievable and I have seen no change. I am wondering if this has been the experience of others who have had this procedure. If so at what point did your thumb begin to bend and then return to fully functioning. Was any further intervention necessary to achieve this?

helpline_team

Hi @Etta

Thank you for posting on our Online Community about your Trapeziectomy operation, we are sorry to hear the recovery hasn't been what you expected, we hope that one of our members will be able to help and share their experiences with you.

I have added a fact sheet below from our Versus arthritis website given information about the operation.

Every surgeon will have a different approach to managing recovery. You will need to keep your hand elevated for at least 48 hours after surgery to prevent excessive swelling.

When you walk, do not let your hand dangle by your side, and when you sit, do not let it rest in your lap. Recovery times vary.

Around two to four weeks after the operation, the dressing/cast will be changed to a light plastic splint. Look out for any redness or infection. The splint can be removed each day to exercise the thumb, or to wash according to specific therapy advice for your recovery.

You will be given a wound review appointment approximately 5-10 days after your surgery. A splint will be made for your hand. The splint can be removed during the day four to six weeks after the operation. It should still be used at night for another two weeks. Physiotherapy can now begin, which will allow the thumb to recover its full range of movement. Any exercise which causes pain should be stopped.

https://www.versusarthritis.org/media/1420/trapeziectomy-factsheet.pdf

Best wishes

Chris

Helpline Advisor

Trish9556

Hi @Etta

I'm sorry you're having so many problems post trapeziectomy. I had mine in 2020 and was back working as a PA in six weeks. My cast was only on for two weeks which probably helped.

Have you been referred to a hand therapist? If you have my first call would be to them. If not you should have.

I was given a simple exercise to start with where I ran my thumb from top to bottom on each finger from the smallest finger to the thumb. It was hard, and will be even harder as you were in a cast for longer than me, but you need to persevere with this even though you won't be able to do all of it at first. Just go as far down as you can.

I suggest you get a pack of therapy putty from one of the onli e selling sites and some therapy balls. These are small egg shaped balls. Both come in different grades and to start with use the softest and simply squeeze in your hand. Think child's play doh. As you progress you can pull the putty and dig your fingers into it.

You could also try picking small things up using thumb and forefinger.

Getting some heat into your hands will help. Use a wheat bag or something like hot hands that are little packs of magic and each lasts about 12 hours. I buy mine from online selling sites by the box load as they're much cheaper. These are perfect to fit inside your hands and inside gloves. Alternate heat with cold as this helps with blood flow. I put my used hot hands into the freezer for this.

The worst thing you can do is to protect your thumb and not use it. The more you don't use it the harder recovery will be.

Finally, sorry this is so long, get a tub of E45, or something that is really thick and gloopy and use it liberally to massage into your wrist and hand.

You really have to persevere, exercises at least five times a day, the more you do the easier it will be. It is hard but you can do this.

Love n hugs

Trish xx

Etta

Hi Trish

I have only just opened this. Thank you so much for your reply it's encouraged me to read all your advice.

I have not heard of anyone else who has been unable to bend their thumb and I have been given no explanation why this is the case. At no point before the operation was I told this might happen and I have found it very frightening. Although it's been eleven weeks since my operation and despite regularly doing the exercises through the day that the hand therapist gave me the range of movement of my thumb is still minimal!

The plaster cast came off after two weeks, I then went straight into a polypropylene split which I could only take off to exercise. This was replaced with a soft velcro fastening thumb splint two weeks ago. I can remove it during the day but have kept it on at night for a further two weeks as told to. It's such a relief to no longer be wearing a splint and I am hoping as you said being able to use it more will mean I will see an improvement.

I have various simple exercises to do but because my thumb will not bend they are not achievable at the moment. Having said that I continue to try I know that is the right thing to do the hand therapist assures me it will bend but who knows when. Running my thumb from top to bottom on each finger from the smallest finger to the thumb will be an exercise I can do further down the road. At present my thumb is rigid apart from the top which I can bend slightly and the whole thumb won't move other than to be parallel to my index finger.

I will order a pack of therapy putty, some hot hands and therapy balls as soon as I finish writing this reply!

A friend also suggested I try picking things up using my thumb and forefinger. As the tip of my thumb bends slightly I am having some success with this which is great and I have things around the house to pick up as I go by.

Please don't apologise for the length of your text, you have given me so much advice and I am very grateful.

Massaging E45 into my wrist and hand I find therapeutic!

I will persevere with the exercises. I have my mobile phone alarm set for every two hours and try to be somewhere I can do them but needless to say, this is not always possible!

I wish I had checked for replies earlier especially as you have given me so much help Trish.

Yes, it is hard but I am determined to regain the use of my thumb and your reply has given me so much help.

On the positive side, my thumb is pain free which is wonderful! It's my left hand and I am right handed! I am due to have my right hand operated on also but I am going to think long and hard about having the operation. I don't have a follow up appointment with my surgeon so will have to wait to discuss this with him pre-op.

I am so pleased you were able to go back to work so quickly, thankfully I have retired so don't have the pressure of trying to return to work with my thumb as it is!

Onwards and upwards!

Love and hugs

Etta xxx

Trish9556

Hi @Etta

I'm not sure why you were told to keep splints on for so long but I'm not a surgeon. Personally I think that isn't helping you to get your movement back. The longer something is immobile the harder it is to recover. When I had shoulder surgery for example I was out of my sling within 24 hours and living it again, albeit painfully!

You could also try plunging your hands into a bowl of hot water (not too hot), and if you have any ping pong balls or bath toys for any grandchildren and simply moving them and trying to pick them up. Blowing bubbles with your thumb and forefinger might help and is fun

Try not to think of exercise to be done at specific times but they can be done any time you're sitting down having a cuppa or watching TV. Although setting a reminder to do them is good if you struggle to get motivated to do them. If this is the case then buy a box if your favourite sweets, biscuits or chocolates and treat yourself to one after every set of exercises. No exercise means no treats!

I'm glad you found my advice helpful, please continue to reach out if you need anything

Love n hugs

Trish xx

Trish9556

PS @Etta

I forgot to say, it took me ages to get my thumb to move from the top to the bottom of each finger, little baby steps and try it when you've just put lots of E45 on to start with. This is a basic exercise that you should keep trying to do and should have been told to do it from when you came out of plaster so please don't sideline this for something to do when you get movement back, it will help get movement back!

love n hugs

trish xx