At TheHealthBoard, we're committed to delivering accurate, trustworthy information. Our expert-authored content is rigorously fact-checked and sourced from credible authorities. Discover how we uphold the highest standards in providing you with reliable knowledge.

Learn more...

What Are the Pros and Cons of a Trapeziectomy? Weighing Your Surgical Options

A trapeziectomy can offer significant relief from thumb arthritis pain, improving hand function and quality of life. However, it involves a recovery period and potential complications like infection or reduced strength. Each patient's outcome may vary. Considering surgery? Weighing the benefits against the risks is crucial. How might this procedure impact your daily activities? Join us as we explore further.
H. Colledge
H. Colledge

Trapeziectomy is a type of hand surgery used to treat arthritis of the lower end of the thumb. The procedure involves the removal of a bone called the trapezium, which forms the thumb's base. Potential benefits of the operation include improved thumb function and relief from stiffness and pain. Possible negative effects, while uncommon, can include infection, loss of skin sensation and, very rarely, chronic regional pain syndrome, where the hand become severely painful and swollen. Recovering from the surgery takes time, and it could be three to six months before strenuous activities are possible.

The kind of thumb arthritis that is treated with this procedure is known as osteoarthritis. Osteoarthritis generally results from gradual wear and tear affecting joint surfaces. As the thumb is used so frequently in daily activities, osteoarthritis of the thumb is a common condition. Symptoms of stiffness and pain are typically experienced, and the thumb may become deformed. The main benefit of a trapeziectomy is that, when other treatments such as painkillers, splints, and steroid injections fail to work, this surgical procedure may provide relief.

A thumb with osteoarthritis.
A thumb with osteoarthritis.

In order to carry out a trapeziectomy, a general anesthetic may be required, although a regional anesthetic, which numbs only the arm, may be used. A cut is made near the thumb's base and the trapezium bone is extracted through it. The resulting space in the joint means that damaged bone surfaces are no longer moving against one another.

A drawback of this surgery is that it is not possible to use the hand normally for a while after the operation. Sometimes, the thumb is held in position using a wire, which sticks out through the skin and is typically removed a few weeks following thumb surgery. A plaster dressing is applied to the thumb for the first few weeks while healing takes place. This is then replaced by a splint, which is worn for about six weeks, and hand exercises are generally carried out under the supervision of a physiotherapist. It may be necessary to wear a softer splint later while recovery continues.

Physical therapy must be used to prevent loss of strength in the arm, and to regain motor control in the hand after a trapeziectomy.
Physical therapy must be used to prevent loss of strength in the arm, and to regain motor control in the hand after a trapeziectomy.

While risks associated with trapeziectomies are low, it is possible that the operation site may become infected, requiring treatment with antibiotic medication. Rarely, bleeding may occur under the skin, or nerves may be damaged leading to numb areas of skin developing over the thumb. Chronic regional pain syndrome, also known as complex regional pain syndrome, is an extremely rare complication that can occur following any type of hand surgery. The hand is affected by extreme pain, swelling, and loss of movement, and it can take several months to treat the condition using a combination of painkilling drugs and physiotherapy.

What To Expect Before, During, and After a Trapeziectomy?

When considering any type of surgery, it is worthwhile to know what to expect at every stage of the procedure.

Before Surgery

Before the surgery, the patient must follow the surgeon's directions, including stopping any noted mediations, fasting, and getting plenty of rest. During pre-operations, the nurse will conduct a brief physical and ask about medical history. 

The patient will need to change into surgical gowns. The nurses and the surgeon will answer any questions the patient might still have.

During Surgery

Osteoarthritis generally results from gradual wear and tear affecting joint surfaces.
Osteoarthritis generally results from gradual wear and tear affecting joint surfaces.

As stated above, anesthesia is administered to the patient, and the surgeon will remove the trapezium. If other adjustments arise during the procedure, such as bone spurs removal or ligament reconstruction and tendon interposition (LRTI), the surgeon will complete that at that time. The surgeon might also need to replace the trapezium with an implant. 

The patient and the surgeon will make most of these decisions before the surgery, but some unexpected things might happen. A typical trapeziectomy can usually last around 60 minutes but may take 90 minutes or more to complete.

After Surgery

Immediately after surgery, a nurse will monitor the patient's vital signs in the recovery or post-operation room. Once the anesthesia has worn off and the surgeon has cleared the patient, they are free to leave and go home for recovery. 

Patients will need to arrange a ride to drive them home from the surgery since the patient was administered anesthesia and pain medicine during the surgery.

Other Risks or Complications After a Trapeziectomy

While a trapeziectomy isn’t invasive, some complications may still arise after having the procedure done.


An individual may not be able to perform basic activities, such as teeth brushing, for a few weeks following a trapeziectomy.
An individual may not be able to perform basic activities, such as teeth brushing, for a few weeks following a trapeziectomy.

After surgery, there will be a scar. The patient's hands and thumb size will determine the scar size. The scar may be red and tender as it heals and sometimes be itchy, but during the physiotherapy sessions, the therapist will advise on how to help the scar heal.

Nerve Damage

Since nerves run throughout the body, there is a chance that the removal of the trapezium during surgery can damage nerves surrounding the area in the thumb. Nerve damage can result in a numb or tender spot on the thumb. The patient may need another surgery to correct the nerve damage.

Reoccurring or Returning Symptoms

Soaking the thumbs in warm water may help sooth arthritic thumbs.
Soaking the thumbs in warm water may help sooth arthritic thumbs.

Although not typical, there is a chance that the trapeziectomy will not eliminate the pain entirely or that the pain may reoccur after a time. Being sure to complete all the physiotherapy sessions and exercises, making lifestyle adjustments, and following all the directions provided by the surgeon, will go a long way to prevent this from happening. 

What Can You Expect During Physiotherapy for a Trapeziectomy?

A few weeks after surgery, the patient will need physiotherapy sessions to ensure proper wound healing and that the thumb can achieve the full range of motion, flexibility, and strength again. The physiotherapist will provide a list of exercises to strengthen the muscles and advise on handling swelling. 

The physiotherapy will also offer tips for scar management. These exercises may include activities such as: squeezing a stress ball, opening and closing a screw-top bottle and stretches for the thumb and wrist. These exercises will not only help to increase the movement of the thumb but will also aid in pain management and finger function. 

The physiotherapy sessions typically last only two to four months but could take up to six months or more for complete recovery. 

What Conditions Need To Be Followed During the Recover Time From Trapeziectomy?

It is essential to follow the surgeon's advice and all the post-operative instructions to guarantee the success of the surgery. It is also essential to attend all the physiotherapy sessions and do all the exercises. Other provisions could include:

  • Keeping the thumb elevated when sitting or laying down to decrease swelling,
  • Monitoring activities not to overexert, and
  • Use caution with daily activities until fully recovered.

What Lifestyle Adjustments Will Be Required After a Trapeziectomy?

What Lifestyle Adjustments will be Required after a Trapeziectomy?

While 94% of patients reported that removing the trapezium reduced the pain in the thumb, some lifestyle adjustments might still need to occur to guarantee complete and lifelong recovery. 

These adjustments could include: exercising the thumb and wrist will help with mobility, strength, and flexibility, and switching to an anti-inflammatory diet that includes fatty fish, fruits, leafy vegetables, and nuts also helps keep inflammation and swelling associated with osteoarthritis at bay.

Frequently Asked Questions

What is a trapeziectomy?

A trapeziectomy is a surgical operation that may help relieve discomfort and swelling in the thumb brought on by arthritis or an accident. In certain instances, the surrounding soft tissue is also removed, as is the trapezium, a tiny bone near the base of the thumb. Doctors may decide to repair the joint as part of the treatment in order to increase function and lessen pain, swapping out the trapezium for a tendon or a tendon transplant in order to strengthen and stabilize the joint.

What are the advantages of a trapeziectomy?

Patients often report less discomfort and swelling in their thumb after having a trapeziectomy. In rare situations, the surgery may even enhance the look of the hand. The operation may also enhance grip strength and joint functionality.

Are there any risks associated with a trapeziectomy?

There are dangers involved with a trapeziectomy, just as with any other surgical operation. Complications could include stiff joints, infection, and harm to the nerves. In addition, the anesthetic utilized during the treatment may cause difficulties.

Age, the degree of arthritis, and other variables may have an impact on how well the surgery goes. It's crucial to go over the possible advantages and disadvantages of a trapeziectomy with your doctor, as well as any potential alternative treatment options.

How long does it take to recover from a trapeziectomy?

After a trapeziectomy, recovery usually takes 4 to 8 weeks. It's crucial to follow your doctor's or physical therapist's advice during this period, which may include resting the hand, administering ice to minimize swelling, and doing range-of-motion and strengthening exercises to enhance joint function.

Is a trapeziectomy permanent?

A trapeziectomy is often seen as a permanent treatment since no new bone is employed to replace the trapezium bone. Physical therapy, however, may help patients eventually recover some range of motion and function in their hands and thumbs as the hand and wrist adjust to life without the trapezium bone.

You might also Like

Discussion Comments


I am now 11 weeks post surgery and I’m still having pain and stiffness in my thumb joint and still have swelling in the area around the scar and base of my thumb. I still cannot put my hand down flat on the floor to do any yoga. I’m very discouraged as I was told after 3 months all would be good. Well 2 weeks away from 3 months and I’m really wondering if I made a big mistake. I feel like I traded one kind of pain for another. Has anyone else still had stiffness and swelling after 3 months?


I had the surgery nine days ago. My cast came off six days after the surgery. Although I continue to take pain meds, the pain isn't bad and the initial swelling and numbness seem transitory. I started driving a week post op. I also have been exercise walking (but with only one pole) as well as riding a spinning bike. I will be starting occupational therapy next week. I'm doing most of my regular tasks, with the exception of opening jars, etc., My surgeon seems to be pushing me to get on with my life, with the expectation that 6-8 weeks will bring normal function, (with possible swelling and residual pain possibly continuing.)

I'm 76 years old, trying to stay active. I just want to encourage those of you who dread the surgery. It is working out very well for me and I'm very happy I had it done. I'm planning to have the other thumb done when I'm completely healed.


I am 5 weeks post surgery and truly regret having the surgery. It has impacted every aspect of my life. The pain I had in my left thumb was nowhere near as bad as the inconvenience and discomfort the surgery has caused. And I’m not convinced that my thumb and wrist will ever be as functional as it should be. So happy I decided against ever getting the right wrist done.


I am five weeks post op and now in a splint. I have no pain but my thumb looks deformed as it sticks out from the side of my hand. I have movement in the joint at the top of my thumb but no movement lower down. Am I being impatient or is this how it should look/ feel?


I had surgery in early April. I'm in a splint now and enjoy being able to take it off occasionally. The pain has been tolerable to this point, and the only real issue has been pain and numbness along my little finger and edge of hand. I've read that this can be a side effect of the nerve block. Has anyone else had this problem?


I had my trapeziectomy surgery in mid April and the plaster removed two weeks later, no dressing put on after and I was given an instruction sheet for exercises to do.

I am back driving, cooking and cleaning, just with a little care taken. Now it does ache if I overdo things, but I am sure another couple of weeks and I will be back to normal.


It has been five weeks and two days since I had the "tight wire" surgery on my left thumb. I am still in a lot of pain. My surgeon said it would take four to six weeks for the pain to leave. Well, it's five more days until the six weeks mark. I see him in two days. I am a 60 year old guitar-mandolin-harmonica player. I fear that this surgery was a mistake.


I am 5 weeks and 2 days after the "tight wire" surgery on my left thumb. I am still in a lot of pain. My surgeon said it would take 4 to 6 weeks for the pain to leave. Well, 5 more days until the 6 weeks mark. I see him in 2 days. I am a 60 year old guitar-mandolin-harmonica player...I fear that this surgery was a mistake...


I got my left thumb done in mid January and had a cast on for six weeks. I've now been out of my cast for two weeks. All my fingers were a bit stiff to begin with, but just gently moving and stretching has worked wonders. I'm now going to get my right thumb done in the next two months. It may not be as easy coping with as I'm right handed, but will be worth it to be pain free at last.


I had surgery on my dominant hand this month, and tomorrow will be three weeks.

I went home with a splint wrapped with an ace bandage until the stitches came out. Then I got a fiberglass cast for four weeks.

I usually have three jobs, but until I heal I only have two days a week when I work. I have been able to mop, vacuum, do dishes, laundry, cook, etc. without much problem beginning three days after surgery. I also drove right away. I only used one pain pill every four hours (like clockwork) instead of the two pills that were prescribed. I might be lucky, or I might be determined by necessity -- either way I just want others to know that you can still be productive.

My main issues have been the inability to twist lids off! Do you realize how many lids you take off on a daily basis? A lot! The other issue is taking care of my hair. My hair is very long and I like to braid it, but all I can manage is brushing it and I can use a spring loaded type hair clip to keep it tidy. I need the same surgery on my left hand and I think I will shoot for next winter as the cast isn't so rough in winter time. No itching, and less odor too. I hope this helps those who are considering a trapeziectomy. My surgeon in La Grande, Oregon "rocks" this procedure in my opinion.


@Melsta57: It has been eight weeks since my surgery and my hand is beginning to feel my own again. I still have limited movement in my thumb and fingers, but everyday things get better.

Before surgery the pain in my thumb was unbearable and stopped me from doing the most simplest of tasks. I feel at this point the surgery has been a successful and well worth the pain and discomfort that all surgery comes with. I know the recovery is long (12 weeks minimum) before you can do the simplest of tasks, but you can then do them free of pain.

Thanks to a great surgical team at the R.O.H. B'ham.


I am three weeks post-op. Having a cast on is very annoying and very limiting. I will have a full cast on now for four more weeks. I'm feeling pressure now which I'm sure is the cast pressing on the wound. If I use my hand too much then it aches.

You just have to learn how to pace yourself. I'm looking forward to a thumb with a lot less pain than I went into hospital with. It is going to take a while to get there. Let's hope it is all worthwhile. --Ginger Ginny


My surgery was done early in May 2013 and although it has been almost six months since the operation, I am still experiencing severe pain at the base of the thumb. I also cannot lift heavy objects without pain and am still taking painkillers. Has anyone else had this problem?


I have been told that when undertaking a Trapeziectomy, it is common practice to leaves shell of bone behind as it is not necessary and virtually impossible to remove the Trapezium in its entirety. Could someone please confirm this? I was of the understanding when I had my operation that the complete bone should have been removed?


I am seven weeks post trapeziectomy. Being in a cast for six weeks was a breeze compared to the past several days. My wrist is swollen, stiff, and almost all movement is painful. I am doing physical therapy now. I'm feeling reassured by the posts that this pain is normal and it'll be worth it in the long run.


I had a trapeziectomy about two and a half years ago and it was life changing. I was only 49 years old and had gotten to the point where I could not even make the bed without being in intense pain. The recovery does take a while, but after I was out of the hard cast (about 10 days), I had a removable splint that allowed me to do most things, including typing.

I will say that I was offered two options: either to fuse the remaining bones or go with the tendon placed where the trapezium used to be. The advantage of the fuse method was better strength, while the tendon method offered more dexterity. I opted for the dexterity, as I don't do a lot of heavy lifting at work. Even today, I cannot lift nearly as much weight at the gym without some pain. Same goes for doing other heavy lifting, like yard work projects. However, overall, I am so happy I had the procedure done. My day to day activities are pretty much pain free, unlike before the surgery.


I'm having this surgery done in June. I am an RN and draw labs from portacaths, PICC lines, and hickman catheters. I also do arm draws for labs. How long before I can go back to my RN duties?


@John57-- The decision to have a trapeziectomy should be between you and your doctor. If you are at the point where the steroid shots don't help, I think you may want to consider the surgery.

Yes, it takes awhile to recover and there is pain involved with the process, but it is a different kind of pain. Once you work through it, you can get to the point where your thumb doesn't have the constant pain. I have been very happy with mine and love being able to do all the little every day things without pain anymore.


How do you know when it is time to have a trapeziectomy? What started out as a little bit of wrist and thumb pain has turned into pain that never seems to stop.

At first over-the-counter medications would help alleviate the pain, but it got to the point where this didn't work anymore. I have received several steroid injections, but these are only a temporary fix. My thumb is starting to look deformed and isn't straight like it should be.

I am really trying to avoid surgery as I don't want to be out of commission for so long, but I think it is getting to the point where I need more relief. For those of you who have had the surgery, have you had good results?


It is amazing how something as small as the thumb joint can cause so much pain and discomfort. I am right handed and the arthritis in my right thumb was the worst. This affected so many things I did like writing, typing, getting dressed, baking, etc.

I finally got tired of fighting it and decided to go ahead with the trapeziectomy. The recovery time was about 4 months before I felt like I had full use of my thumb again, but I sure wish I had the procedure done sooner than I did.


fBoyle-- Doing the exercises and physical therpay after any kind of surgery or injury is always the hardest part! Not only does it take discipline to even do the exercises, but it usually hurts at first which makes it even more difficult. Even though I eventually felt a lot better after my trapeziectomy, it wasn't easy being diligent with the exercises.


The worst part about a trapeziectomy surgery is the hand exercises they make you do ten times a day, so boring! I also hated going to the regular appointments with the therapy nurse.


@alisha-- Do you still have your cast on?

I did experience that kind of pain after my surgery but it basically went away once my cast was removed. I think what happens is that the cast can put pressure on the incision area and that makes you feel more pain than you would have otherwise. I think you will be okay once the cast is removed.

I have no complaints about my trapeziectomy. I had severe arthritis and my thumb had become completely stiff. I really couldn't move it and therefore couldn't use my hand before the surgery. Five months after the surgery, it was as if I got a whole new thumb. There is no stiffness nw, no pain, everything is just wonderful. I wish I had gotten the surgery sooner.


It's been three weeks since my trapeziectomy surgery and I'm still in a lot of pain. The pain started as soon as the anesthesia from the surgery wore out. First it was a dull ache and now it's more of a throbbing pain.

Is this normal?

I know it takes a long time for recovery, but to be honest, I was not expecting pain like this. The surgery went great, everything was easy, post-surgery is a lot harder it seems.

Post your comments
Forgot password?
    • A thumb with osteoarthritis.
      By: aboikis
      A thumb with osteoarthritis.
    • Physical therapy must be used to prevent loss of strength in the arm, and to regain motor control in the hand after a trapeziectomy.
      By: aykuterd
      Physical therapy must be used to prevent loss of strength in the arm, and to regain motor control in the hand after a trapeziectomy.
    • Osteoarthritis generally results from gradual wear and tear affecting joint surfaces.
      By: joshya
      Osteoarthritis generally results from gradual wear and tear affecting joint surfaces.
    • An individual may not be able to perform basic activities, such as teeth brushing, for a few weeks following a trapeziectomy.
      An individual may not be able to perform basic activities, such as teeth brushing, for a few weeks following a trapeziectomy.
    • Soaking the thumbs in warm water may help sooth arthritic thumbs.
      Soaking the thumbs in warm water may help sooth arthritic thumbs.