Thumb CMC Joint Arthroplasty
Following a thumb CMC joint arthroplasty (joint replacement) for arthritis at the base of your thumb, a bulky post-operative dressing will be applied to your hand and wrist. This bulky dressing will remain on your hand and wrist until your first follow-up visit with the surgeon. During this time, you should exercise your fingers gently to prevent stiffness. You will not be able to move your thumb due to the dressings. You will need to keep your arm elevated to decrease edema (swelling).
Your first follow-up visit with your surgeon will be 10 to 14 days from your surgery date. At this time, your bulky dressings will be removed and your sutures will be removed. You will then be fitted with a cast, which will immobilize your thumb and wrist. This will stay on for 4 weeks. At this first follow-up visit, you will be referred to an Occupational Therapist who specializes in hand injuries. You will be instructed in additional finger range of motion exercises.
When you return for your 2nd follow-up visit at 6 weeks from the date of your surgery, your cast will be removed and you will be fitted with a removable splint. You will return to hand therapy to begin gentle thumb and wrist exercises. You will also be instructed in scar massage for your incision site. Aggressive long-term therapy is not recommended, unless you have more stiffness than is usually expected.
Your 3rd follow-up visit will be 3 months from the date of your surgery. At this time, you may be allowed to stop using your thumb/wrist splint and resume most activities.
Following a thumb CMC joint arthroplasty, you should expect the following:
- Your hand and wrist will be immobilized for 6 weeks. You should plan to pre-sign checks, open tight jar lids and prepare food to store in the freezer if you live alone. This is especially important if you are having surgery on your dominant hand.
- You will not be allowed to perform any resistive (strengthening) exercises for 3 months from your date of surgery. Please don't start using any strengthening exercises, including a 'squeeze ball' until you are given clearance by your surgeon or therapist.
- Your incision scar may be slightly hypersensitive. Your therapist can give you suggestions to help with this.
- You may have edema (swelling) in your wrist and thumb for several months after your surgery. Your therapist will instruct you in a variety of methods to decrease edema.