Trapeziectomy

Trapeziectomy is a surgical procedure that involves the removal of the trapezium bone, which is one of the eight small bones in the wrist.

Indications for Trapeziectomy

• Osteoarthritis: Trapeziectomy is often performed to treat osteoarthritis of the thumb, particularly when the joint between the trapezium and the first metacarpal bone (the base of the thumb) is affected.
• Thumb pain: The procedure can also be used to relieve pain in the thumb caused by other conditions, such as rheumatoid arthritis or a previous injury.
• Joint instability: Trapeziectomy may be necessary when the joint between the trapezium and the first metacarpal bone is unstable, causing the thumb to be weak or difficult to move.

Surgical Procedure

The trapeziectomy procedure typically involves the following steps:

1. Administration of anesthesia: The patient is given local or general anesthesia to numb the area and prevent pain during the surgery.
2. Incision: A small incision is made in the wrist, usually about 1-2 inches long, to access the trapezium bone.
3. Dissection: The surgeon carefully dissects the tissue and ligaments surrounding the trapezium bone to expose it.
4. Bone removal: The trapezium bone is then removed, usually in its entirety, although sometimes only a portion of the bone may be taken out.
5. Joint reconstruction: After removing the trapezium bone, the surgeon may need to reconstruct the joint between the first metacarpal bone and the surrounding bones to maintain thumb stability and movement.
6. Closure: The incision is closed with sutures or staples, and a dressing is applied to protect the wound.

Postoperative Care and Recovery

After trapeziectomy surgery, patients typically require several weeks of recovery time. The following are some general guidelines for postoperative care:

• Pain management: Patients may experience pain, swelling, and bruising after the surgery, which can be managed with pain medication and ice packs.
• Immobilization: A splint or cast is usually worn to immobilize the thumb and wrist for several weeks to allow the joint to heal.
• Physical therapy: After the initial healing period, patients may need to undergo physical therapy to regain strength and mobility in the thumb and wrist.
• Follow-up care: Regular follow-up appointments with the surgeon are necessary to monitor the healing progress and remove any sutures or staples.

Risks and Complications

As with any surgical procedure, trapeziectomy carries some risks and potential complications, including:

• Infection: Bacterial infection can occur after surgery, which may require antibiotics or further treatment.
• Nerve damage: The nerves surrounding the trapezium bone may be damaged during surgery, leading to numbness, tingling, or weakness in the thumb or fingers.
• Blood clots: Blood clots can form in the legs or lungs after surgery, which can be life-threatening if left untreated.
• Joint instability: The joint between the first metacarpal bone and the surrounding bones may become unstable after trapeziectomy, leading to weakness or limited mobility in the thumb.

Outcomes and Prognosis

The outcome of trapeziectomy surgery can vary depending on individual factors, such as the underlying condition being treated and the patient's overall health. Generally:

• Pain relief: Most patients experience significant pain relief after trapeziectomy surgery.
• Improved function: The procedure can improve thumb mobility and strength, allowing patients to perform daily activities with greater ease.
• Satisfaction: Many patients report high satisfaction rates after trapeziectomy surgery, citing improved quality of life and reduced pain.