Your CMC joint connects your thumb to your hand. The joint allows your thumb to move in many directions, but it’s vulnerable to arthritis.
CMC replacement removes the small trapezium bone from the joint and replaces it with a wrist flexor tendon, alleviating pain and restoring mobility to your thumb. It’s usually an outpatient procedure.
The team at Beaufort Orthopaedic Sports & Spine recommends CMC replacement when you have severe arthritis in the CMC joint and conservative treatments don’t relieve your symptoms.
For example, your doctor might try to treat your condition with anti-inflammatory medication, steroid injections, splinting, or activity modification. If these measures aren’t effective, they may recommend surgery to restore your joint mobility and relieve your pain.
Your doctor reviews your preparation instructions in detail during your pre-surgical consultation.
In general, you need to arrange for a friend or family member to drive you home after your appointment, wear comfortable clothing, and avoid eating or drinking anything for at least seven hours before your appointment.
After providing anesthesia and preparing you for surgery, your surgeon begins by making a small incision near your CMC joint. They carefully remove the small trapezium bone from your wrist.
Next, your surgeon makes a small incision in your forearm, releasing a wrist flexor tendon. They attach the tendon to the base of your thumb bone, and the rest of the tendon is placed in the space left by the trapezium bone. The tendon creates a flexible cushion for the remaining bones.
Finally, your surgeon closes the incisions with sutures and covers your hand and forearm with a bandage and cast. Immobilizing the wrist and thumb in the correct position helps you heal correctly.
A friend or family member can drive you home after your anesthesia wears off and your doctor has reviewed your aftercare instructions. You need to keep your cast dry until your surgeon removes it, approximately two weeks later at your first follow-up visit.
At this point, your doctor teaches you some gentle exercises and stretches to practice at home to help restore strength and flexibility. You start physical therapy six weeks after your surgery.
Depending on what you do for a living, you can go back to work after a week or two; if you need to use the hand that was operated on to do your job, you may need to wait six weeks. It takes time to restore your full range of motion and strength.
Call Beaufort Orthopaedic Sports & Spine or make an appointment online today for expert hand surgery, including CMC replacement.