A trapeziectomy is the complete removal of the trapezium bone – one of the eight carpal, or wrist, bones. It is located at the base of the thumb, which is a common site for arthritis, because the range of motion of the thumb predisposes the joint to instability and increased wear. It is a condition that eventually leads to increased joint stiffness, pain, and ultimately deformity in the thumb. While activity changes, anti-inflammatory medication, splints and steroid injections can temporarily alleviate symptoms, surgery is the only permanent solution.
A trapeziectomy is indicated when the joints both above and below the trapezium are arthritic. More frequently today a simple trapeziectomy with a small modification, also known as hematoma and distraction arthroplasty, is used – and yielding a high success rate. In this procedure, the trapezium is removed in small sections, and Kirschner wires (K-wires) are used to help internally stabilize – affixed to the first metacarpal in slight distraction and opposition. The procedure is then followed by a period of immobilization.
The procedure successfully eliminates pain and dramatically improves range of motion and grip and pinch strength.