After Surgery Instructions for Ligament Reconstruction Tendon Interposition Thumb CMC Joint Arthroplasty
Elevation of the thumb and wrist is very important. For most of the week, you should try to keep your hand between the ceiling and your heart, regardless of position you are in. For sleeping, the arm may be placed on a pillow over the chest, or on pillows out to your side, or you can sleep rolled up on the other side with pillows in front of you. When sitting, try to keep the hand elevated on pillows. When walking, also try to keep the hand up above the heart. We do not use slings because it is very difficult to keep the hand elevated in a sling, and it is important to keep your shoulder and elbow moving. When elevating, the elbow must not be kept in one position – it should not be kept flexed or bent the whole time.
Ice applied over the operated area may help in the first 3 to 4 days. The ice should be kept in a plastic bag or cool pack in order to keep the dressing dry. It can be used intermittently. Not all the cold gets through because of the bulk of the dressing, but some gets through.
Finger motionis good to do. Try to straighten the fingers as much as possible, and then bend them as much as the dressing allows. This should be done on a frequent, but not repetitive basis. The distance that the fingers move is what is most important.
Light lifting with the arm that has been operated on is acceptable.
The dressing should be kept in place, as well as clean and dry. For showering, a plastic bag can be wrapped around the dressing.
If you have problems or questions after this surgery, please call the Cedar Valley Hand Surgery office, 319-364-2697. Whenever possible, please call during normal office hours.
Elevation will not be as important at this point, but may still be needed at times if the arm is painful or fingers swollen. The cast or splint still needs to be kept clean and dry, with a plastic bag again used for showers. Most patients do not require pain medications at this point, although Tylenol or Advil may be needed occasionally. Finger motion exercises should still be done periodically.
5th through 7th week
The splint is worn for all activities, and for sleep. More use of the operated hand and arm is possible, with the splint protecting the surgery.
The incision scars from surgery should be massaged with lotion twice a day for three to 5 minutes, during one of the periods that the splint is removed.
Range of motion exercises should be continued during this period. Strengthening exercises are added to the exercise regimen, and exercises should be done 3 to 4 times a day. These are taught and supervised by the therapist.
Scar massage to all incisions should be continued, 2 times a day for 3 to 5 minutes.
Splint wear is acceptable for very heavy activities or for periods of activity-related discomfort on an as-needed basis. Most patients are able to resume full, unprotected sports and activities without the need for a splint by three to 5 months after surgery.