Base of Thumb Arthritis Treatment

Treatments Available

Non-operative treatment

• Rest, pain killers (analgesia)
• Avoiding aggravating activities
• Resting night splint          

Operative treatment

• Injection under x-ray control. This is carried out under clean environment in a minor procedure unit or the radiology department. Up to 70% of patients notice an improvement in their symptoms after an injection and hand therapy. Risks of steroid injection includes infection, fat necrosis leading to thinning of the skin and skin depigmentation (both are permanent changes), poor diabetic control up to 2 weeks and failure to resolve symptoms in up to 30% of the patients.
• Surgery: the type of surgery depends on the nature of the arthritis, age and physical demand of the patient.
  • Fusion of the thumb CMC joint in young and active patient, where trapezium is fused to the thumb metacarpal.
  • Trapeziectomy and ligament interposition in older patients. This procedure is performed under general anaesthetic or regional anaesthesia (wide awake surgery when only the arm is made numb during the surgery). The surgery takes about 1 hour. The trapezium is excised. Half of a thumb tendon is then used to create a suspension sling or hammock to stabilize the thumb and fill up the space that was created by removing the trapezium. A half plaster slab is applied after the wound is closed.