Basal joint arthritis of the thumb is an arthritic condition in which the cartilage cushion between the bones of the wrist and the thumb wears out. Surgery to replace the joint consists of using a piece of tendon from the forearm to act as a joint cushion, as well as rebuild a ligament.
Weeks 1-2:
- You will go home from the hospital in a thumb spica cast which will remain on for three to four weeks.
- Elevation of the thumb and wrist is important. Elevate while sitting, sleeping,and walking. It is best to keep the hand above the heart.
- Ice can be applied to the operative area.
- Bend and straighten the fingers as much as the cast will allow.
- Actively move the elbow and shoulder through full available range of motion.
Weeks 3-4:
- The cast, dressing, and sutures will be removed.
- You will be issued a removable thumb spica brace.
- Tensogrip for inflammation.
- The splint can be removed for gentle passive range of motion of the wrist and thumb, including flexion, extension, opposition, and abduction. Active range of motion of the wrist and fingers can be started.
Weeks 4-5:
- Initiate active range of motion of the thumb.
- Blocked PIP thumb flexion and extension.
- Finger tendon glides.
- Full fist.
- Desensitization.
- Scar massage.
Week 6:
- Begin resistive range of motion of the fingers, thumb, and wrist, i.e: putty, grippers, sponges, weights, tubing.
- Advanced desenstization.
Week 8:
- General upper extremity strengthening and conditioning.
- Return to previous level of activity.
- Removable thumb spica brace as needed for repetitive, aggressive activities.
