About Me:

 

I am a Consultant Hand and Upper Limb Surgeon and my NHS practice is based at the Brighton and Sussex University Hospital Trust;  this includes Haywards Heath Princess Royal Hospital and The Royal Sussex County Hospital.

I specialise in the following areas of Orthopaedics:

 

  • Hand, wrist and elbow conditions, injuries (including soft tissue sports injuries) and treatments, including:

  • Elbow surgery

  • Hand surgery

  • Wrist Surgery

Base of Thumb Arthritis

Description:

Arthritis affecting the joint at the base of the thumb is one of the most common reasons for having arthroplasty (surgery to the joint itself).  The base of the thumb is made of a saddle-shaped joint and it is very mobile and therefore prone to wear and tear changes (ostearthritis).  When this occurs, usually an x-ray of the thumb is taken by a hand surgeon and the treatment that may be required is discussed. 

 

Treatment:

This may range from physiotherapy and splinting, injections or surgery.  Surgery for this condition can either involve fusing the joint so that it no longer moves and is therefore no longer painful, or removing a bone at the base of the joint, so that it maintains mobility and is no longer painful.

 

In some people, fusion would be preferred and in others, the removable of the bone at the base of the thumb is the preferred option (trapeziectomy).  Which treatment is best for an individual patient needs to be decided upon after careful examination and discussion between the hand surgeon and the patient. 

 

There are joint replacements available for the base of the thumb and these are said to provide a more mobile and stronger grip at least in the short term. These are certainly an option for some individuals; however they do carry a risk of dislocation, which results in a higher complication rate than the other procedures that I carry out more commonly. At the present time if a joint replacement is requested for basal thumb arthritis I would refer onto a colleague locally.

 

Surgery to the base of the thumb usually requires an overnight stay in hospital and the procedure is carried out under a general anaesthetic.  The thumb is splinted in a cast for 3-4 weeks, after which a removable splint allows gentle mobilisation, if a trapeziectomy has been performed, but the fusion surgery usually requires more rigid immobilisation for a period of 6 weeks.

 

Complications:

Both the above operations carry greater than 85% satisfaction rate, but full recovery may take more than a few months