Thumb Arthroplasty vs Fusion

Hello and welcome to HealingWell.  My choice would be tendon interposition arthroplasty with ligament reconstruction.  I need to have this procedure myself but for some reason keep putting it off. 

My hand surgeon never mentioned fusion to me so I do not have any info re that topic but hopefully one of our other members will have some input for you.

Kindly,

Kitt 

Hi, I just had the CMC arthroplasty on 2/6/12. For anyone about to have this surgery, stock up on 800 mg Ibuprofen. I was taking 2mg of dalaudid every 4 hrs the first day and it didn't help. I started taking the Ibuprofen and it stopped the pain enough to get me through the first couple of days. After that it was pretty tolerable.

hi, i have had a fusion of cmcj a week ago. its slightly painful at the moment, my surgeon explained to me that as i am quite young (39) and i have a fairly heavy job, the fusion was the best option for me. not really sure how long the recovery process is going to take, but hopefully, it will be worth it in the end.

Just had my second cmc arthroplasty in 2 years and am typing with one hand. Currently casted and counting down the days till the cast comes off. I think it's the worst part of this. I got a good outcome the first time - no more pain and so decided it was worth it again. Would not do the fusion if I could avoid.

I just had my second CMC replacement surgery on 3/25/13. My first surgery was on 11/4/11. I had a nerve block in my neck so I did not feel much pain the first day. As soon as the block wore off the second day, I started feeling moderate to severe pain so I took the prescribed Dilaudid 2mg. Not much help so my doctor suggested taking two 2mg Dilaudid every four hours. This helped with pain but I cannot take pain killers because they tend to make me nauseous, so I am currently taking 800 mg of Ibuprofen and keep an ice pack around my cast 20 min. on/off. The first surgery worked really well for me as the pain in my thumb has significantly subsided. Occupational therapy after surgery is very important and of course time. I am confident that I will have the same positive result for my second surgery (too soon to tell). I highly recommend this surgery as it tremendously improved my quality of life. In addition, having a good hand surgeon is very important. Personally, I am very happy with my surgeon and I think this makes a world of difference. I hope this helps.

Depends on the type of surgery you are having on your hand, Frogluvr8. Thumb, wrist, finger? Tell us more and perhaps we can come up with what others experienced.

I'm 55 still active got to the point that my left hand was worthless. I'm in construction had to resort to easy work like painting and stuff I hate to do. My hand surgeon stated that fusion was the way to go due to my younger age and the fact that I can bear weight and still work with my hands. Be ready for a nerve block they went under arm pit with long needle but was not bad after was hitting myself in the face with my hand tho I was put under and 6 screws and a plate and I have had a cast on for three weeks got 2 left so can't wait to see how it works he also did a carpal tunnel relief at the same time. I will be posting after cast is off and we will see how she works.good luck too all

CMC Arthroplasty. Here is a recent report. Would be happy for new discussion with current patients:

5 plus weeks out from LRTI (CMC arthroplasty with tendon transfer) on left, dominant hand. It has been pretty brutal, but X-rays show the surgery to be in good shape. Hand is stiff, painful and unusable. Just went on 2 weeks of Prednisone to get swelling down. Did first week of physio therapy. Working consistently at home.

I am 68. Surgery on May 27. 10 days in bulky bandages with Cold Therapy sleeve inserted. This pumps cool water through continuously. A must have. You can use until you get stitches out. Then, into hard cast. Super uncomfortable. I think it was too tight. Went back for a new one, but still the pain. Lots of pain in wrist, which I think is result of the surgery and immobilization. At week 4, that came off and into splint. Still could use pain meds, but am not getting them. I am a migrainier and very sensitive to pain.

TIPS:
Females wear skirts with no underwear for ease in bathroom. Take mild laxative first week if you are taking opiate pain killers.

I only did sponge baths with husband help for first 4 weeks. Good enough. Had hair washed in sink. Did not want to deal with covering post-op bandage, and a waterproof hard cast. Did get a professional pedicure. Nice to have feet massaged and cleaned.

Use microwave hot pads lots. No proof that they help with healing, but they sure feel good. Don’t use ice after you get out of hard cast. Not good for raw nerves. Also, the contrast cold and hot baths reported on before are now contraindicated. Too traumatic on healing tissue.

In kitchen, have Styrofoam cups, plastic bowls. Much easier for lifting.

I use “meditation for pain” CD’s on my MP3 player with headphones. Can be a relief and at least can lull you to sleep.

Once you are out of cast, do lots of massaging with oils and cocoa butter/with E on hand and fingers—always stroking down toward elbow to move lymphatic fluid out of hand.

Elevate hand above heart as much as possible, but watch out for shoulder and elbow stress.

No, doctors never educated me on this tough recovery process. One tough part is the mental. You just feel your hand and health is so vulnerable. Don’t want any slipups on damaging the surgery aspects. I am hoping getting to week 6 will make me feel tougher.