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  • Q&A with Australian Health Practitioners

    Trapeziectomy - are there alternatives?

    Are there alternatives for someone with a bone spur to trapeziectomy? As the recovery time seems to be long and not guaranteed to work I cannot afford to be immobile for 8-12 weeks.
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  • 2

    Thanks

    Dr Simon Chan

    Hand Surgeon, Orthopaedic Surgeon

    Dr Simon Chan treats patients with all hand surgical conditions. His main areas of interest include carpal injuries, complex wrist fractures, finger joint replacements and … View Profile

    Dear Anne

    Trapeziectomy is an operation performed for basal thumb arthritis.

    The basal thumb joint is a very mobile joint. Quite significant forces also go across the joint. Basal thumb arthritis is therefore quite common.

    Treatment for arthritis consists of treating the symptoms of arthritis. I discuss surgery with patients after a trial of non-operative measures.

    Non-operative treatment measures include:

    • Activity modification
    • Hand therapy (splint, proprioception exercises and strengthening of specific muscles that control the basal thumb joint)
    • Simple pain killers (Paracetamol, Non-Steroidal Anti-Inflammatory Drugs)
    • Corticosteroid injections
    • Stronger pain killers

    These should all be considered before surgery.

  • Erika Lassig

    Occupational Therapist (OT)

    Erika has over 10 years experience practising hand therapy. She has worked in hand and upper limb rehabilitation at a variety of centres including Logan … View Profile

    As mentioned above, a spur on the trapezium is a symptom of osteoarthritis of the trapezium, which forms part of the carpometacarpal joint of the thumb, otherwise known as basal thumb joint or first CMC joint. Osteoarthritis is wear and tear on the the joints caused by degeneration over time or from an injury. Symptoms experienced include pain, swelling, reduced movement, and in some cases deformity.

    Therapy management of arthritis, while not curing the disease, is aimed at equipping you with strategies to manage your condition so that you can continue carry out your daily tasks with the least amount of discomfort. Therapy may also help prevent progression of the disease or further deterioration. 

    Typically, therapy includes a splint or orthosis that is designed to support the affected joint and slightly restrict movement. This may be an off-the-shelf product or a custom-made orthosis. The splint is worn during particularly painful periods or activties. Exercises are prescribed to strengthen the stabilising muscles and ligaments of the thumb CMC joint. Education regarding activity modification is a vital part of treatment to enable participation in daily tasks without pain.

    It is also important to have a GP or hand surgeon involved in your care to prescribe appropriate pain-relieving or anti-inflammatory medications. You may also find the use of a heat pack such as a heat wheat helpful to relieve aching joints.

    You can find a therapist skilled in hand therapy on the Australian Hand Therapy Association Website www.ahta.com.au

    I hope you find the non-surgical solution that you are looking for.

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