CMC Suspensionplasty FAQs
What is a suspensionplasty?
Surgery to address chronic pain from basilar thumb joint arthritis consists of removing one of the carpal bones of the hand known as the trapezium. Removing this bone can alleviate pain. In order to stabilize the thumb after removal of this bone a "suspension" is made between the thumb and index finger using small titanium buttons and strong suture material. This maintains the thumb in proper alignment.
How do I know if I need surgery?
If the pain from arthritis cannot be controlled with conservative treatment surgery is often performed. The recommendation to proceed with surgery is based on a variety of factors including surgeon recommendation, overall health, as well as failure of conservative treatment. We believe all of your questions and concerns should be addressed before surgery so that you are comfortable with your decision.
What are the risks of surgery?
Risks of surgery include blood clots (DVT/pulmonary embolism), bleeding, infection which can require reoperation, damage to nerves or blood vessels. Other risks include potential anesthesia complications such as heart, lung, kidney, liver, or brain damage.
How is my surgery scheduled?
If Dr. Wilson has recommended surgery and you have consented, you will be contacted by one of our surgery schedulers, and a date for your surgery will be set. The time of day your surgery occurs is based on many factors and if you have a specific need or request please let them know. Our surgery scheduler will coordinate insurance authorizations, specialist referrals, and post-operative therapy as well as follow-up office appointments. They will contact you several days before surgery to inform you what time to arrive for your procedure.
What will I do on the day of surgery?
You may use the free valet parking if desired and signage is marked throughout hospital grounds. You will present to the outpatient surgery desk on the second floor of the hospital where you will check in. They will verify your identification and update any insurance/billing issues and you will be taken back to a private room where nursing staff will prepare you for surgery. Your family may not accompany you initially but may be allowed to come to your room once you are deemed ready by the nursing staff. Dr. Wilson and/or his Physician Assistant Adam will see you before your surgery and answer any final questions you might have. Your family/friends will wait in the outpatient surgery lobby while you are in surgery. Dr. Wilson will call your designated contact upon completion of the surgery to inform the procedure is complete. You will not be allowed to drive home from the hospital and will need to arrange private transportation.
How long will my surgery take and how long will I be in the hospital?
CMC suspensionplasty is a short procedure which will take approximately 20-30 minutes, and is performed under general anesthesia. Upon leaving the operating suite you will be taken to the PACU (Post Anesthesia Care Unit) for 1-2 hours until you are ready for discharge home.
Pain is a subjective measure that each individual experiences differently. Pain control requires a multimodal approach and may include preoperative nerve blocks, intraoperative local anesthesia, and postoperative oral pain medication. If you have an allergy or intolerance to specific medications this should be mentioned before your surgery. You will be given a prescription for pain medication as outlined in full detail in the attached portion of this packet regarding our office’s policy on prescribing of narcotics. You will be expected to decrease your narcotic use quickly in the postoperative period. Dr. Wilson will not prescribe any narcotics greater than six weeks post-op and if pain control is still an issue a referral to a pain management specialist may be required.
How long is my recovery?
Your wrist will be placed in a splint after surgery. At your two week appointment you will be referred to physical therapy and will need to wear an orthotic for 6 weeks after surgery. Wrist and hand strength usually returns by about 3 months after surgery. It can take up to 6 months to obtain full strength. Driving, self-care activities, and light lifting and gripping are permitted soon after surgery. Return to work is based upon your profession and workplace demands. Someone with a sedentary or office job often can often return after 4-6 weeks. If you have a physically demanding job 10-12 weeks of leave may be necessary.
What else can I do to prepare for surgery?
We ask that you enroll in MyChart prior to your surgery in order to provide a more efficient and effective means of communicating with our office. Our staff will be happy to help you enroll. You may be required to have medical clearance for your surgery based upon your past medical history. This may entail encounters with your primary care provider or other specialists (cardiology, pulmonology, endocrinology, etc.) to ensure you are optimized for surgery. Several tests, such as blood and urine samples, and EKG may be necessary. Your functionality will be decreased after surgery and preparing your home is helpful to reduce risks of injury or complication. You may need assistance with daily activities including bathing, cooking, shopping, and laundry.
Where can I find additional reliable information about my surgery?
The American Academy of Orthopedic Surgeons has a very informative and easy to navigate webpage including pamphlets and videos about your procedure. You may visit www.orthoinfo.org