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Old 12-19-2010, 10:06 AM   #1
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mom23reds HB User
Question CMC joint fusion ?

In August I started having pain in my left thumb/wrist so bad that I couldn't even pick up my quart bottle of water with my left hand. Of course, I sit in bed to work on my laptop and my water bottle is on my left side. I saw my family doctor on September 2nd and he diagnosed me with deQuervain's tenosynovitis. Since I cannot take any anti-inflammatories (had gastric bypass surgery 3 years ago), he immediately put me into a spica thumb splint to enforce resting of the joint.

Fast-forward to October when I'm STILL in pain even with the splint and it's not getting any better, though the tenderness in the wrist when he does the diagnostic test for DQT is much less. He prescribes a buffered NSAID, which I just couldn't bring myself to take a full daily dose of because of my fear of bleeding ulcers. With my stomach being separated from the esophagus, if I get an ulcer I have to have surgery to diagnose and correct it.

Forward to late November, I'm still in the splint and still in pain. I tell my doctor that I figure I'm just going to have to live with the pain. He doesn't accept that and sends me to the specialist having done all he can do to help me.

I saw the specialist on December 14th. He looks at the x-rays from mid October and says, "Oh there's your problem. You ruptured the volar beak ligament and have bone on bone in the CMC joint because your thumb is not riding properly in the trapezium bone joint."

Oh. Ok, so what are my options?

1. Anti-inflammatories - ummm, no. Gastric bypass patients can't take anti-inflammatories

2. Splinting - I've been in it for 3 1/2 months already. I can't live the rest of my life in this splint!

3. Surgery - either fusion or removing the trapezium and putting a tendon in there. He recommends fusion because the other surgery may not last but 15 to 20 years and I'll be in worse shape when I reach 60 to 65 years old with the potential of living to 80 to 85 years old.

So my question is have you had the fusion done? If so, how long were you out of work (I spend about 65 hours a week at the computer doing my job and relaxation)? Was it on your dominant hand? How long before you felt comfortable using the hand/thumb?

This would be on my dominant hand. Right now, I cannot open a bag (like a cereal bag or cheese bag), I cannot lift more than 1 lb (tried to grab a 2 lb package of little smokies yesterday and nearly passed out from the pain), but can mostly type with the splint on though I get more spaces than I really want.

In looking at my busy lifestyle, I'm thinking I need to go ahead and get the surgery done NOW so I can start healing and be back to post-operative normal so that I can go to Boy Scout summer camp July 3 - 9 in Oklahoma. I'm also Girl Scout cookie mom for our troop, but I can get my husband and kids to help me with that and then other parents and girls to help with cookie booths. Luckily high school band isn't very active in the Spring compared to the Fall, so that shouldn't be an issue, though middle school band will get more busy in the Spring.

Any help and suggestions would be appreciated. The doctor did do a cortisone injection on the 14th. It's helped some, but I still don't have pinch/grip ability without pain. I just don't have the constant long-term pain that I had before.

Susan

 
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Old 12-20-2010, 07:23 AM   #2
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lca8461 HB User
Re: CMC joint fusion ?

Hi Susan,
I had the CMC joint with tendon replacement on July 15th. I can tell you with this surgery, you would be in a cast for up to 8 weeks, then you would have to start physical therapy. They say it takes up to a full year to get full fuction back. I have however, been derailed with my recovery. The joint above has locked up and the joint closest to the tip of my thumb has taken on all the work. I have over 50% pinch, so I am able to function, but the surgereon is not happy with the result. That being said, I no longer have that constant, grinding pain of having nothing between the joints. That alone made the surgery well worth it. I know of only one other person who considered joint fusion. if you look at some of the other threads like 'Basal joint surgical treatment..Effective???' and 'CMC Joint Arthroplasty' that can provide you with additional information. My surgeon indicated in his 30 + years of doing this surgery he had only had to replace 2 that the tendon had stretched out.

 
Old 01-25-2011, 11:58 AM   #3
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wandacantrell HB User
Re: CMC joint fusion ?

Hi... I just had a CMC arthroplasty with a fusion of 2 bones in my wrist... The pain has subsided greatly.. I am just having to get use to not being able to move my wrist like before.. I am only 3 months out of surgery (Oct. 26,2010) and had my pins removed from my fusion on Dec. 28th... My doctor told me it would take at least 6 months for my hand to get better.. It is still stiff and does hurt... but IT DOES NOT HURT AS BAD AS MY LEFT THUMB... which I am also going to have done.. My thumb joint was bone on bone . I am able to touch my all my fingers to my thumb and can make a fist and almost get my thumb under my index finger... Consider the surgery.. It is a long haul.. I was in a splint for 2 weeks after surgery.. then I was in a cast for 4 weeks then a spica thumb splint for 3 weeks.. Now I am in nothing and can use my hand as I can...

 
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