FREQUENTLY ASKED QUESTIONSQ. Fasting before Operation?
A. Nothing to eat or drink at least 6 hours before the operation.
Q. Anaesthetic?
A. General or arm block anaesthetic can be used.
Q. Duration of Operation?
A. About 60 minutes.
Q. Pain?
A. Local anaesthetic is instilled at the time of surgery. You will be given oral pain relief to take home. Elevating the hand in a sling or on a pillow will assist with pain relief.
Q. Will I be in a plaster after the operation?
A. Initially, you will be in a “half cast” or plaster slab, to allow for any post-operative swelling. Depending on your operation, this may be changed to a removable plastic splint or full cast at 10 days, to be used for a further 4 weeks.
Q. Will I need physiotherapy after the surgery?
A. Immediately after the surgery you will be encouraged to move your fingers, elbow and shoulder. Once the cast is removed, specialist hand therapy treatment will help the rate of recovery and your final result.
BASE OF THUMB ARTHRITIS
WHAT IS IT?
The joint at the base of the thumb (carpometacarpal joint) is a reasonably common area to develop osteoarthritis, particularly in middle-aged women.
It presents as worsening pain and ache in the base of the thumb, weakness of pinch strength and muscle wasting around the thumb. In severe cases, contracture of the joint can lead to the thumb being drawn into the hand.
WHAT CAN BE DONE?
Initially, simple stretching activities and oral anti-inflammatories may help. If the problem persists, injection of cortisone into the joint and specialised hand therapy treatment can often give long-term relief.
If these measures fail or the problem is too advanced, there are good surgical treatments to fix the problem.
Depending on the individual, the joint may be replaced using a local tendon spacer or artificial joint. In some cases, the joint may be stiffened (fused) to relieve pain and maintain surprisingly good movement and strength.
WHAT ARE THE RESULTS OF OPERATION?
Usually, the pain around the base of the thumb resolves. As the pain is relieved, pinch strength and function of the thumb (and hand) are improved and most people return to full activities.
In patients with severe contractures, the thumb is placed back into a functional position, allowing significantly improved hand function.
All the risks from surgery are low, but include stiffness of the thumb or fingers, infection, continuing pain or failure of bone healing (with a fusion).