In this Q&A video, Mr Oliver Harley shares his expertise on a number of hand conditions, including how a trapeziectomy can help thumb arthritis, and symptoms and treatment for carpal tunnel syndrome.
He also reveals when finger joint replacement surgery may be considered to alleviate pain for patients suffering from arthritis in their fingers.
Q1. How can a trapeziectomy help thumb arthritis?
A. It's quite common for people to start getting pain at the base of the thumb where the thumb joins the hand, and there's a little bone in there called trapezium, which is about the size of a pencil sharpener, and this bone can get arthritic. If the pain is bad and consistent enough, we can help simply by removing the trapezium bone, and the thumb seems to work really quite well without the need to have this bone. So, the operation takes about an hour to do, it's usually awake surgery, it’s day case surgery, and you go home and start having some physiotherapy the following week. Sometimes it's quite painful to begin with, but the pain subsides and usually by the time you reach about three months after surgery, you're starting to really notice that the thumb is much, much better than it was before.
Q2. What is carpal tunnel syndrome?
A. Carpal tunnel is an extremely common condition of the hand, it can affect one hand or both hands. It causes typically tingling, soreness, and pain, and it usually affects all fingers except the little finger, but there are some variations. Sometimes people get symptoms from time to time, sometimes people get symptoms all the time. If the symptoms are bad enough, we can treat it with surgery, day case, awake surgery, and I want people to start using their hands straight away after surgery for gentle activities and slowly build up, and usually, people will be feeling much better from the carpal tunnel symptoms, even within a day or two, but they do get some soreness in the heel of the hand, and it takes some time for that to work through. But the main thing is that people can start doing gentle activities straight away after surgery.
Q3. When would I need a finger joint replacement?
A. It's perhaps a little-known fact that there are joint replacements which are available for the joints of the fingers. Each of your fingers has three joints in it, and any, or all of those joints, can be involved with arthritis. Often people with arthritis have other joints that are much more troublesome, but there are plenty of patients out there who will have fingers that are painful from arthritis. Usually, it's the case that people will manage with painkillers - either painkillers that you take by mouth or rubbing or even inject into the joints - but sometimes things can get so bad that a joint replacement is the best way of moving forward, alleviating the pain, and still allowing you to have some movement within the finger.
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