Taking pain medication can help you deal with the pain and swelling. After some surgeries, the hand may be immobilized for months at nighttime to enhance recovery. She serves as an assistant professor at the Yale School of Medicine, and practices in Bridgeport, Connecticut. You can learn more about how we ensure our content is accurate and current by reading our. In severe thumb sprains, your ligament can be partially or completely torn, which often needs surgery. It can also help restore movement in the affected fingers or thumb. This is usually temporary. You can also elevate your hand to reduce swelling. Doctors keep the wire in for 4 to 6 weeks to allow the area to heal. Often, the two ends of the tendon are very damaged and cannot be sewn back together. 2023 Cedars-Sinai. Summary. During a trapeziectomy, the trapezium bone is removed and the space is filled with a tendon graft or an implant made from silicone or metal. LRTI is a serious surgery with a lengthy recovery time. 2021;86(6S Suppl 5):S622-S624. Steven Shin, MD, treats elite athletes in his clinic, but you don't have to play for a professional team to benefit from his groundbreaking technique for treating thumb ulnar collateral ligament (UCL) injuries. People should. Experiencing pain and tenderness around the base of your thumb. The operation can take approximately 30 minutes. Recovering from surgery. The main advantage of ligament reconstruction is the stability it provides, but it does not repair the bone or cartilage. What can I expect after thumb arthritis surgery? Once the first month of recovery has passed, the K-wires and stitches will be removed. Osteoarthritis is the most common form of arthritis associated with the aging-related degeneration of joints. Heres What You Need to Know. This technique is less invasive and has a shorter operating and recovery time. After surgery, patients will need to undergo rehabilitation and physical therapy to regain full range of motion. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. These include: You will also be instructed to stop eating before midnight on the eve of your surgery. Systematic comparison of ligament reconstruction with tendon interposition and suture-button suspensionplasty for trapeziometacarpal osteoarthritis. The technical name for arthritis of the thumb is basal joint arthritis. Sometimes, a silicone or metal implant is used instead of a tendon from your wrist. Surg Neurol Intl. This involves manipulating special hand putty with different levels of resistance. Youll be weaned off the splint and start gentle activities with the affected hand. DOI: sters N, et al. If youre experiencing pain in your thumb, contact your healthcare provider. Long-term results of modified ligament reconstruction and tendon interposition for thumb basal joint arthritis. A trapeziectomy is a surgery used to treat trapeziometacarpal osteoarthritis, also known as thumb arthritis. In some cases, your doctor may perform a combination of these treatments. Lessons learned: Trapeziectomy and suture suspension arthroplasty for thumb carpometacarpal osteoarthritis. Examine your thumb, and you'll feel two bones, known as phalanges. Duerinckx J, et al (2022). But theres a third bone in the fleshy part of your hand known as the metacarpal. This explains why its painful to pinch or grip when you have thumb arthritis. Your surgeon will likely remove a protective splint or cast after the procedure. Your surgeon will make an incision on the skin over your thumb joint. Early results of the ARPE arthroplasty versus trapeziectomy for the treatment of thumb carpometacarpal joint osteoarthritis. Your joints are lined with smooth tissue known as cartilage. He notes that there are virtually no downsides. The first week after surgery will involve immobilizing the hand with a wire. (2016). Jennifer M. Edwards, The Healthline Editorial Team. Rehabilitation involves protecting your tendons from overuse using hand . Ligament reconstruction and tendon interposition (LRTI). You won't be allowed to drive home after surgery, so be sure to arrange for a ride. The goal of physical therapy is to regain full range of motion in your thumb. But theres less research available to support their effectiveness. David S. Ruch, professor of orthopedic surgery at Duke University in North Carolina, says LRTI has a 96 percent success rate. You can also get a treatment plan that will help get your thumb back to normal again. Dermal fillers are more popular than ever, but its a good idea to consider several factors before you take the plunge. The remaining portion of the FCR is cut off and preserved in gauze. Take a piece of tendon from your wrist muscle. The putty comes in graduated resistance levels to use as your strength increases. . This technique involves removing the trapezium and temporarily installing a wire (called a Kirschner wire or K-wire) to immobilize your thumb. When a group of muscles contract (tighten), the attached tendons will pull on certain bones. To do this, he or she removes a small bone in the wrist near the base of the thumb and passes a nearby tendon through the hole in the thumbs metacarpal bone. Policy. How long does pain last after tendon surgery? Ruch notes that many studies indicate thumb arthritis is 20 to 25 times more likely to occur in women than in men. As people age, the thumb joint becomes a common site of arthritis. After thumb arthroplasty, patients should expect pain and swelling for approximately six to eight weeks. Both types of tendon surgery require a lengthy period of recovery (rehabilitation) because the repaired tendons will be very weak until the ends heal together. If you have a moderate thumb sprain (grade 2 sprain), treatment can include: If you have a severe thumb sprain (grade 3 sprain), treatment can include: Everyone experiences pain from time to time, but persistent pain isnt normal. Overview of Finger Joint Replacement (Arthroplasty), Overview of Radial Head Arthroplasty Procedure, More noticeable differences in appearance. Physical therapy should be started soon after surgery. Additional surgeries are uncommon. . Our website services, content, and products are for informational purposes only. The ligaments that hold the joint together can also loosen, causing it to slip. A typical recovery timeline looks like this: Your surgeon will give you specific instructions on how to change dressings and wash the incision site once your cast is removed. Aroke EN, Robinson AN, Wilbanks BA. But experts don't currently recommend collagen for routine treatment of joint pain because more data is needed to confirm it's effective. To perform this surgery, a surgeon can use either a ligament from your body to cushion the joint or insert metal, silicone, or plastic prostheses. How long after UCL surgery can you hit? It is also washable, however, pay attention to the advice given for the specific therapy. Shin developed the approach after learning of its success in ankle surgeries, with patients being able to bear weightand even jumpwithin days instead of weeks or months. All rights reserved. . Discuss this with your doctor and seek a second or third opinion. British Columbia Department of Health. Procedures can vary depending on where your trapeziectomy is performed. The three different grades include: Grade 1: A grade 1 thumb sprain is a mild sprain. We avoid using tertiary references. Recovery times can vary from several weeks to several months. If the nerve has been compressed for a long period of time, recovery may take even longer . Many people experience pain relief after LRTI surgery. Cost analysis and national trends in the treatment of thumb basal arthritis: comparing ligament reconstruction/tendon interposition and trapeziectomy/hematoma distraction arthroplasty. Live surgery thumb arthroplasty and ligament reconstruction (LRTI) for arthritis. This may involve heat therapy or manual therapies. (2016). Shah K, et al. Most people experience an improvement in their arthritis symptoms after a trapeziectomy, including decreased pain and improved use of their thumb for gripping, pinching, and grasping. How long you need to wear it will vary based on the specific injury. For example, tendon repair recovery can take up to 12 weeks for your hand to return to full strength and up to 6 months for you to regain a full range of movement. Therapy will include squeezing and manipulating special hand putty to strengthen your fingers and thumb. . Some people can continue to gain strength for one to two years. How long does it take for thumb surgery to heal? Pain After surgery, your hand will be painful. Which is the best method for CMC surgery? All rights reserved. Thumb sprains, and other types of sprains, can range from a stretch or small tear in your ligament tissues to a complete tear through your ligament or a detachment from your bone. Whether the wrist is broken or ligaments are injured usually depends on many things, such as how strong your bones are, how the wrist is positioned during the injury, and how much force is involved. The suture is then used to repair the ligament as is done traditionally. With that said, it may take time before you can regain full use of your thumb and hand. SEBASTIAN KAULITZKI / SCIENCE PHOTO LIBRARY / Getty Images. It is important that no physical activity is performed by the injured thumb because it can prolong the healing time. Copyright 2004-2023 Duke University Health System, Hand and Upper Extremity Surgeon, Microvascular Surgeon, Orthopaedic Surgeon, Newer, Less Invasive Thumb Arthritis Surgery Significantly Reduces Recovery Time. During the first two to three weeks, they can do simple tasks with the affected hand, such as eating and writing. The wire will be removed around six weeks after the operation. If they use a ligament, the procedure is known as ligament reconstruction and tendon interposition (LRTI). During the procedure, the thumbs carpometacarpal joint is exposed through a 2-inch incision, and then the trapezium is removed in its entirety. Thumb-basal joint arthroplasty outcomes and metacarpal subsidence: A prospective cohort analysis of trapeziectomy with suture button suspensionplasty versus ligament reconstruction with tendon . This can help avoid complications or healing problems you may not recognize. A grade 3 sprain may require surgery to repair the ligament. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Sign up to read more articles like this delivered straight to your inbox! (https://pubmed.ncbi.nlm.nih.gov/21536628/). Your MCP joint is located at the base of your thumb near your palm, in the webspace. Physical therapy typically begins four to six weeks after surgery. Earlier studies published in the Cochrane Database of medical outcomes also indicated that trapeziectomy alone may be better for you than a complete LRTI. Still, the Arthritis Foundation notes that the procedure is somewhat controversial. There isnt much consensus in the medical community yet regarding its effectiveness and perhaps a lack of specialists trained in this procedure. Some people do explore non-surgical options for these treatments, this may include an array of stem cell therapy or Platelet Rich Plasma therapy.If you are exploring these options please understand that in our . Patients who spend most of their time at home will need to take closer to six weeks off from work. The second joint, where the second bone of the thumb meets the bone of the hand (metacarpal), is called the metacarpophalangeal (MP) joint. The problem may start when the strong tissue (ligament) that holds the joint together loosens up. A tendon transfer is a surgery that moves a working muscle and tendon to replace a non-working muscle and tendon. Your surgeon may also remove part of your thumb bone. Be careful when using your hand for everyday tasks involving gripping, lifting, pushing, or pulling. A mild sprain usually heals within four to six weeks if you wear a splint or cast to immobilize your thumb and refrain from activities that irritate it. Patients who undergo CMC arthroplasty will typically be outpatient for a few weeks. The information below gives you a general idea of what to expect. (2020). Shin has performed hundreds of these procedures over the past six years, which has also been done on knees, elbows and wrists. The surgeon reattaches the ligament to the bone using stitches (sutures) and small anchors. Physical therapy will focus on restoring full range of motion and strength to the thumb. This often happens from falling on your outstretched hand. A splint will also protect the repaired tendons. Whats the Difference Between Arthrodesis and Arthroplasty? RHA is a surgery for injuries to the head of the radius bone or for wear and tear from arthritis. Surgery is usually only necessary for severe. Two to four weeks after the surgery, the dressing or the cast will be changed to a light plastic splint. However, the number who experience complete relief of symptoms after surgery may be only 50%. These exercises will help patients regain strength and flexibility of the thumb joint. This allows the bones to slip out of place, causing wear to the cartilage. This can make it difficult to straighten your fingers. Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey. Ann Plast Surg. Extensor tendons, located on the back of the hand and fingers, allow you to straighten your fingers and thumb. He or she will remove part or all of your wrist bone. The remaining tendon is then rolled like an anchovy to provide additional support. It can provide effective relief of the pain of thumb arthritis for many people. Trapeziectomy. Some discomfort when putting pressure on the palm is normal for 4-6 weeks after surgery, for example when crawling, pushing out of a chair, or leaning on the hand with the wrist extended. Doctors have performed this surgery for decades, often improving symptoms and thumb function. Most thumb sprains involve your ulnar collateral ligament (UCL), which is located on the inside of your thumb at the first metacarpophalangeal (MCP) joint. But it is more expensive and more likely to create complications. Your doctor will prescribe a physical therapy program that emphasizes range of motion and strengthening of the wrist and forearm using isometric exercises. This artificial joint may be made of metal, plastic, silicone rubber, or your own body tissue, such as a tendon. Grade 3: A grade 3 thumb sprain is a severe sprain. Be sure to follow your surgeon's pre-operative instructions to avoid complications or the possible delay of your procedure. Fold and tuck the ends of the tendon so that it fills the space where your trapezium was. Prevention The gracilis tendon, a lesser groin tendon that inserts in the front of the knee. Imaging tests for diagnosing a sprained thumb can include: The treatment for a sprained thumb depends on how severe your sprain is. By the start of the third month, youll begin a gradual return to normal daily activity. Be gentle with movements at first; full movement can be expected to return in 1 to 2 weeks. Once the cast and splint have been removed, the patient will begin physical therapy. See additional information. . Qureshi M. (2022). The trapezium is a nugget-shaped bone in the wrist situated immediately beneath the long bone of the thumb, called the metacarpal bone. People who are at a higher risk of falling are also more likely to get a sprained thumb. You may be able to use your hand right away, but you may have to take at least two weeks off work for a full recovery. Theyll then perform a physical exam to assess the stability of your thumb joint and where the pain is coming from to determine if the injury is or isnt a sprain and how severe the injury is. This surgery, which restores a normal range of motion in the thumb, prevents the disease from progressing. With fiberwire ligament reconstruction, recovery time is shortened to three months. Most people get complete pain relief from LRTI, but recovery time is long and sometimes painful. At the base of thumb is the trapezium bone. Follow your healthcare providers instructions on how to care for your sprained thumb. DOI: McClellan T. (2012). A splint or cast ensures that the thumb is in the right place to heal correctly. In addition, you should know that your hand will be swollen for several weeks. Total joint replacement for osteoarthritis of the carpometacarpal joint of the thumb: Why and how? Patients may return to work as early as one week after surgery. CALL 1300 762 227. Partial torn finger ligaments generally takes around 6 weeks at best or longer under comprehensive-care from professionals.Meanwhile severe injury may require up 12 or more months (depends on part,severity etc). Thumb sprains are a common injury. Wear safety equipment when you play sports. These included: This compares to adverse effects in only 10 percent of people who had their trapezium bone removed (trapeziectomy), but no ligament reconstruction and tendon interposition. Your doctor might recommend a foam wrist-elevation pillow or other device. The most common cause of CMC joint breakdown is arthritis. This results in the inability to pivot, turn, or twist the leg. 001) and runs (P < . . Need to s. Read More. Still, there are downsides: Total joint arthroplasty (aka total joint replacement) involves removing the damaged bone surfaces and replacing them with a prosthesis. If you are younger and very active, with a lot of demand on the joint, a doctor may recommend synthetic spacers because metal prostheses can fail with heavy use. Exercises and physical therapy will help you return to your normal activity level gradually over the next few months. The symptoms of a thumb sprain depend on how severe the sprain is. It provides the advantage of continued pain relief after the operation is over. Jammed finger. If you have a sprained thumb and are experiencing new or concerning symptoms, contact your healthcare provider. Keep in mind that theres no remedy if youre among the 22 percent of people with LRTI who have complications. Many injuries are work-related. How long does a sprained thumb take to heal? A 2022 systematic review found that SSA and LRTI had similar outcomes, but more research was needed before drawing any conclusions. 3 in the nation by U.S. News & World Report. Keep your recommended medical appointments even if you feel OK. Use metal retractors to hold open the incision. Physical therapy is also a vital part of your recovery process. Rehabilitation may include strengthening exercises to regain strength. Your doctor will discuss different surgical options and help you decide which one is right for you. What is the recovery time for CMC arthroplasty. A doctor may be able to correct breaks closer to the end of the thumb through external manipulation. Our hand therapists are some of the best in the country and really pushed to keep patients immobilized for three weeks instead of six weeks, which resulted in a significantly faster recovery time.. The thumb accounts for about 40% of the use of the hand, so almost everything in life becomes more challenging, Ruch says. The goal is to regain full range of motion, meaning you can touch the tip of your thumb to the pad of your pinky finger. Youll also want to find out how long you can expect the pain to last. In LRTI, all or part of the trapezium bone is removed from the wrist and the remaining surfaces of the CMC and STT joints are smoothed out. We avoid using tertiary references. Four or five days after surgery, your postoperative dressing will be removed, you'll get a removable splint and begin physical therapy. The splint is only removed when washing or doing post-operative wrist exercises.