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imagolfer 08-24-2011 01:27 PM

Basal Joint Surgery Procedures
Hi Everyone,

I am considering having surgery on my thumb(s) and wanted to reach out to see if anyone has had the procedure that my Dr. is recommending.
It appears that most of the surgeries on the Basal joint of the thumbs involve removing the trapezium bone and then "harvesting" a tendon from your wrist and coiling it in the space where the trapezium bone was.
My Dr. said that he would be removing the trapezium bone, placing a pin to "hold open the space" until scar tissue formed (which will act as the "cusion" between the joint)...then in 6 weeks, he would remove the pin & place me in a removeable cast for another 2-3 weeks - then PT after that. Any responses would be appreciated.

OhioQuilter 08-29-2011 08:56 AM

Re: Basal Joint Surgery Procedures
Hi. I had this surgery on July 19th this year. I did not have a pin holding the wound up tendon in place. I was in a semi-hard cast (hard on the bottom, a little softer on the top) for ten days. On the 10th day I saw the doctor and had a splint custom made to fit my left hand. I wear it all the time, except when I shower. (I do "cheat" on occasion but not much.) I have seen the therapist once (August 19) and had the splint redone because the swelling had gone down and my splint was a little too loose.

I am doing very well - the pain I had before is essentially gone. At first of course there is some post-surgery pain but that diminishes after several days. I get occasional twinges but mostly I am very glad I decided to do the surgery. I am right handed, and next year I'll probably have the right hand done as I have basal joint arthritis in both hands. I am hoping I'll be able to go back to knitting, quilting, gardening, crocheting once my left hand is healed and I can use my thumb better.

I was really very frightened to have this surgery so I feel like I summoned up a lot of courage to do this. I even thought that if anyone asked me on the day of the surgery "Are you sure you want to have this?" I would have changed my mind on the spot and left the hospital! But I'm glad I did not. I had a lot of anxiety before the surgery, worrying I would cripple myself. I'm very glad to say that is not the case. I'm even typing this response to you with my left hand in the splint, typing nearly as fast as I used to before surgery. Good luck! Let me know if you have the surgery.


imagolfer 08-29-2011 09:45 AM

Re: Basal Joint Surgery Procedures
Hi Dorothy!
Thank you for replying...and I am so happy to hear you are getting along so well (and so quickly!). Did you, in fact, have the "coiled tendon" put in place of the trapezium bone in your surgery? The specialist at UW/Madison said he has done many of "those types" of surgeries, but that he was going to be doing something "different" with mine ~~ which is NOT replacing the bone with a coiled tendon..but in fact, placing the pin in until scar tissue is formed to "fill the space" where the bone was removed. That is my main concern is that I have not heard of anyone who has had the surgery who did NOT have a tendon put in. Needless to say, I am a bit skeptical (and nervous).


OhioQuilter 08-31-2011 08:02 PM

Re: Basal Joint Surgery Procedures

Yes I did have the coiled tendon put in the space where my trapezium bone had been. The surgery your doctor wants to do was the 3rd option my doctor mentioned to me (the first was to fuse the bones so the thumb would have limited movement - sounded extremely awful to me so I never considered that.) The option you describe was told to me by my doctor to involve suturing the thumb bone to the pointer finger bone (bottom of both bones) and the sutures would stay in place for an indeterminate amount of time. He did not mention using a pin to hold that space open. (Frankly I'm glad because the idea of a pin being in place sort of grosses me out. But that's just me.) And he did also mention that the space would fill in eventually with scar tissue and such. I decided NOT to try that kind of surgery because Dr. Stutzman said it was still a relatively "new" procedure and had not been taking place for a very long time - I think he said it's been used for the past 10 years or so. And no one is certain how long that set of sutures would hold the bones in place. The theory was that the scar tissue would fill in enough (like the rolled up tendon thing I opted for) and even if the sutures broke eventually, it should hold. It sounded like a possibility, but I liked what I had been reading on the web about the type of surgery I had. My doctor stayed very straight-faced - he didn't try to influence me for any one of the three options. He let me decide for myself. I'm glad I did what I did because it worked out so beautifully for me. I just saw him today for my 2nd post-op visit and he was quite pleased to hear me say, when he asked about pain,and I answered "Minimal - an occasional twinge but that's all."

It's up to me to decide when to have the right hand done. I know I'll have it done eventually, but I'm still splinted on the left hand. I want to be sure I have almost complete use of the left hand before I do the right. He said Im going about it the right way - wait until I'm comfortable with the timing of doing the right hand, and be sure I am back up to par with my left hand before deciding to do the right hand.

Hope this helps. I'll look forward to hearing back from you.

p.s. Today is my birthday!

imagolfer 09-03-2011 06:38 AM

Re: Basal Joint Surgery Procedures
Hi Dorothy,

....a bit late, but Happy Birthday! Thanks for the response & detailed explanation of your procedure. The more I read, the more convinced I am that using a tendon to fill the space where the bone is removed, is the more prevalent and "tried and proven" procedure. I will definitely have that discussion with my Dr. and go from there.
Thanks again and the best of luck...both now & eventually with your other hand!


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