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Base of Thumb Arthritis - Suspensionplasty

Indications

  • Gold standard.
  • Mid to late stage arthritis of the CMC (base of thumb) joint including with instability and joint subluxation.
  • Aim is to remove the joint surface and stop the arthritic joints rubbing together.
  • Long-term benefit.

Investigations

  • Plain x-rays are usually all that is required.

Surgery

  • Usually overnight stay procedure, most commonly under general anaesthetic +/- a block.
  • Via an incision at the base of the thumb, sometimes with a second incision in the mid forearm.
  • The bone is stabilised by a combination of tendon and sutures.
  • Usually takes approximately 60 minutes.

Post operatively

  • Immediately post operatively the hand is usually quite numb due to local anaesthetic used for the surgery.
  • The thumb and wrist will be in a plaster backslab and the fingers will be free.
  • It is important to keep the hand elevated after surgery especially in the first 72 hours post op to reduce/limit swelling.
  • Keep the fingers moving, all the way straight and bent into a fist to limit stiffness and help reduce swelling.
  • May use the hand for light activities as comfortable but avoid heavy activities.
  • Keep the dressing clean and dry.
  • Review at 2 weeks for wound check and to change to removable plastic splint.
  • Begin Scar massage to soften wounds and desensitise scars.
  • Takes 6-12 months to fully recover.

(Bone has been removed and ligaments stabilised, note space at base of thumb)

(Incision)

(Severe Arthritis of Base of thumb and STT joint)

These notes have been prepared by orthopaedic surgeons at OrthoSport Victoria. They are general overviews and information aimed for use by their specific patients and reflects their views, opinions and recommendations. This does not constitute medical advice. The contents are provided for information and education purposes only and not for the purpose of rendering medical advice. Please seek the advice of your specific surgeon or other health care provider with any questions regarding medical conditions and treatment.