Trapeziectomy Treatment

What is Trapeziectomy Surgery?

The trapezium is a small bone in the wrist at the base of the thumb which is usually affected by arthritis. The trapezium is the cube-shaped bone present in the wrist that is joined to the base of the thumb (trapeziometacarpal joint). Trapeziectomy is a surgery which involves the removal of a small bone (one of eight which form the wrist) called the trapezium. This is present at the base of the thumb. This produces more space for the thumb for the movement so that the arthritic bone surfaces are not rubbing together which result in pain.

What are the benefits of Trapeziectomy Surgery?

The main benefit of the surgery is to relieve the pain and improves how the functioning of the thumb. 

Left Thumb Trapeziectomy

A left thumb trapeziectomy is a surgical procedure that is done with a goal of treating limited arthritis in the carpometacarpal joint of the left hand. It is a surgical exercise in which the trapezium which is the bone on the palm side of the wrist at the base of the thumb is surgically removed because it is usually the bone that is most affected by arthritis pain.

Partial Trapeziectomy

A partial trapeziectomy- again a lesser invasive method of surgery- is carried out for arthritis at the base of the carpometacarpal (CMC) joint. In the past the doctor used to perform the surgery by eradicating the entire structure of the trapezium bone, but now the doctor only carries the surgery on that specific area that is infected with arthritis or is damaged.

Symptoms leading to Hand Surgery Trapeziectomy 

Trapeziectomy is considered when symptoms originate from arthritis at the base of the thumb- predominantly the osteoarthritis. Some of these symptoms have a serious impact on the daily living and the general well-being of an individual.

Common symptoms include:

• Pain
• Swelling and Inflammation
• Weakness
• Limited Mobility
• Deformity
• Crepitus (Grinding Sensation)

Complications due to Hand Surgery Trapeziectomy:

• Wound complications: Possible problems include bleeding, swelling, bruising, blood collecting under the wound (hematoma), infection, and splitting open of the wound (dehiscence).
• Scar: Depending on the size of the hands, the patients will have a scar over the thumb base which is around 2.5 inches in length. The scar may become red and a little thickened as it heals, but this will settle down with the passage of time. The scar will be tender, and this will also settle, firm massage with a plain cream or oil will help in healing the scar.
• Incomplete relief of pain: 90 percent of patients experience a good amount of pain relief following the recovery period
• Persistent weakness of pinch grip: Before the patient’s operation pinch grip is often reduced due to pain from arthritis. While the patient’s grip strength should be improved following the operation (as the pain is being resolved) it will not be returned to its pre-arthritic condition.
• Nerve damage: There are small nerve branches that run in the area of the cut. The nerve can be damaged during the surgery and this may leave either a numb area on the back of the thumb or a small tender point that may require another small operation for excising the tender spot.
• Further surgery: Should there be a complication that needs another operation, then the doctors will discuss this with the patients. Occasionally arthritis can develop at the neighboring joints and requires treatment. Sometimes there is some instability after the bone is being removed; a ligament reconstruction can be performed for this instability and thus securing the thumb.
• Complex regional pain syndrome: This is a syndrome of stiffness, swelling, and pain that happens in about 5% of people following the surgery. The symptoms are out of proportion to the nature of the operation. At the moment, it not sure why this occurs and it cannot be predicted to whom it will happen. The doctors will monitor the patients for this after the operation, and the treatment usually involves special forms of pain relief and physiotherapy. Osteoarthritis at the base of the patient’s thumb can cause pain when they use their thumb and prevent them from performing any daily activities. A trapeziectomy can help in relieving the pain and so improve how the thumb works.

Causes leading to Trapeziectomy Treatment

Trapeziectomy is most often used to treat arthritis of the base of the thumb (carpometacarpal or CMC joint) and is also called as CMC Trapeziectomy.

Several causes can lead to the need for this procedure, including:

• Osteoarthritis
• Rheumatoid Arthritis
• Post-Traumatic Arthritis
• Repetitive Strain or Overuse
• Genetic Predisposition
• Age-Related Changes
• Joint Instability

What does the operation involve?

• The operation will generally involve the patients coming in the hospital for a day. 
• The patient’s arm may be numbed with the help of a regional anaesthetic or with the help of a general anaesthetic. 
• A small cut is being made at the base of the thumb and thus the operation is being carried out. 
• After the surgery is being performed, a bulky dressing is applied for the purpose of protecting the thumb. 
• During this time it is vital to keep the hand elevated which helps in getting rid of the swelling and to move the fingers to prevent them from getting stiff.  
• After the span of two weeks, the dressing and stitches are removed, and a lighter splint is being made which will allow the patients to use their hand for light activities while the thumb is being protected. 
• Once the wound is completely healed it is safe to get the hand wet the patients must make sure that it is dried well before the splint is being reapplied.  
• At this stage, the patients can moisturize and massage the scar. 
• After four weeks the patients will be taught some exercises, which are to be performed out of the splint. 
• However, the splint is to be worn for the purpose of the protection and at night for a total of 6 weeks.  
• How much the patients should do with the hand at this stage depends on how much pain they are in. 
• If it hurts when using the thumb then the patient must rest the thumb back in the splint.

Recovery Period for the Patients:

• The patients should be able to go home the same day. 
• The patients must keep their hands raised for 2 weeks. 
• The bandage or plaster cast will only be removed after 4 to 6 weeks. 
• It is vital for the patients to gently exercise their thumb and fingers which help them to recover. 
• The patients must gently exercise their elbow and shoulder to prevent stiffness. 
• Regular exercise should help them to return to their daily activities as soon as possible. 
• Before the patients start exercising, they must ask the healthcare team or GP for advice. 
• The thumb should continue to improve over the next year as the patients get back a good range of movement.

Are there any alternatives to surgery?

• The patients can adapt their lifestyle to prevent some particular activities that make the pain worse.
• Simple painkillers can usually provide good relief; advice about what may be suitable to the patients can be gained from the doctors.
• Splints which may be custom made, or bought ‘off the shelf’ can immobilize the thumb joints and provide support and thus relieving the pain.
• Steroid injections can usually provide good relief; the benefit is, however, short-term only.

Best Hospitals for Surgery to Remove Trapezium Bone

• Artemis Hospital, Gurgaon
• Medanta The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket
• BLK-Max Super Speciality Hospital, New Delhi

Best Doctors for Surgery to Remove Trapezium Bone 

• Dr. Ramkinkar Jha
• Dr. Ashok Rajgopal
• Dr. Subhash Jangid
• Dr. Vikas Gupta
• Dr. Puneet Girdhar

Why Choose GetWellGo for Trapeziectomy Treatment?

Trapeziectomy treatment is undertaken by GetWellGo which has a strong tie up with some of the most widely reputed orthopedic hospitals and surgeons in India.

Here’s why you might consider them:

• Expert Medical Team
• Affordable Treatment Packages
• Visa Assistance
• Travel and Accommodation Services
• Language Support
• Personalized Services

FAQ

1. What are these Benefits of Trapeziectomy?

• Pain Relief: Reduces or eradicates chronic pain resulting from arthritis, a common ailment, or condition among many people.
• Improved Thumb Function: Helps to extend the strength of grasp, pinch and use their hands in any normal handling function.
• Durability: There are few consequences similar to those related to joint replacement implants, because the results tend to last a lifetime, especially when there are no such problems, as prosthetic failure.
• Minimally Invasive Options: Ligament reconstruction and tendon interposition (LRTI) in present day procedure can actually minimize recovery period and enhance the results.

2. What is the Success Rate?

• The procedure is highly effective with success ranging between 80% and 95% with the vast majority of patients reporting changes that are permanent with regards to pain and function.
• They got some sort of mild residual weakness, however noticed that their pain more often than not has been significantly reduced.

3. What is the Recovery Time?

Short-Term Healing:

• After surgery the limb is immobilized for 6-8 weeks, wearing a splint or a cast.
• Pain is usually relieved by about 50% in one month.

Full Recovery:

• In some cases, depending on the chosen approach to the surgery and the patient himself, complete rehabilitation and return to normal functioning may take from 3 to 6 months.
• Doctors may prescribe a physical or an occupational therapy that will help rebuild the muscles mass and flexibility and movements.