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Trapeziectomy

Trapeziectomy is a procedure to remove the trapezium bone. This is one of the small bones of the wrist and it sits at the base of the thumb. Arthritis of the joint between the trapezium and the base of the thumb is very common and it can lead to a painful and/or unstable joint. The first treatments for arthritis here are modifying activity, use of anti-inflammatory medications, steroid injections and splints. If these are not sufficient to relieve symptoms or in more advanced cases, surgery is considered.

The trapezium is usually removed to relieve pain from arthritis in the joint between it and the thumb. After the bone is removed, a ligament reconstruction using part of a wrist tendon can be performed. I reserve ligament reconstruction for cases where the base of the thumb is very lax after removal of the trapezium. There is very little long term difference between simply removing the bone and removing the bone plus doing a ligament reconstruction.

Afterwards, a splint is worn all of the time for two weeks. After this, hand therapy commences and the splint can be removed to do exercises and gradually for all of the day, only being worn at night. This continues until six to eight weeks postoperatively when the splint is discarded. By twelve weeks, recovery is usually complete. While this operation is very successful at relieving pain, it does not improve the power or strength of the thumb.