The basal joint of the thumb, also called the carpometacarpal joint, is technically a saddle joint even though it exhibits the multidirectional movement of a ball-and-socket joint. Situated at the base of the thumb, close to the wrist, this joint is able to move in five different directions. Basal joint surgery is often warranted in elderly patients to treat chronic arthritis. Younger patients receive surgery for joint instability, which can be caused by sports injuries or trauma.
Recovery Expectations
The recovery is dependent on the invasiveness of the surgery, age of the patient, and contributing health factors. Typically, the sutures come out 10 to 14 days after surgery and a cast goes on to stabilize the joint for eight to 12 weeks. A shorter immobilization period may be prescribed if pins were used to fix the bones. Full recovery is estimated to be after. 16 weeks.
Range of Motion
To regain the five movements of the thumb, hold each position for 30 seconds. Rest your hand on the table with your palm facing up. Point to the base of the pinky finger with your thumb. Rotate your hand so it is resting on its side, thumb facing up. Raise the thumb away from the hand. Press the thumb into the hand. Rotate your hand so the palm is facing down. Raise the thumb from the table. Finally, touch the tips of each finger with the end of the thumb. Repeat each movement three to five times, three times a day.
Fine Motor Skills
Fine motor skills refers to small muscle movements, which are stunted during the immobilization after surgery. To regain these skills participate in activities involving slight and precise movements of the thumb and hand such as: playing cards, writing with a pen, picking up individual coins from a table, doing up buttons on a shirt, or flipping the pages of a book. To progress the exercises increase the time or precision of the activity.
Gross Motor Skills
Gross motor skills refer to the use of large muscles of the upper body. To regain these skills participate in activities that involve large, upper body movements such as: catching and throwing a ball, tennis, wall climbing, rope climbing, crawling or sweeping the floor. Similar to the fine motor skill strengthening, progress these exercises by increasing the time of the activity or the grasping strength required.
References
- "Surgical Anatomy of the Hand"; Hans-Martin Schmidt, et al.; 2003
- "ASSH Manual of Hand Surgery"; Warren C. Hammert, et al.; 2010
- "Physical Therapies in Sport and Exercise"; Gregory S. Kolt, et al.; 2007
- "Operative Techniques in Hand, Wrist and Forearm Surgery"; Thomas R. Hunt; 2010
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