Trapeziectomy

Removal of the trapezium so that the worn thumb-base joint no longer exists; the space fills with scar tissue and the thumb settles slightly. The standard operation for painful thumb-base arthritis, with good pain relief in about four in five people at five to eighteen years; pinch strength does not return to normal. Adding a tendon sling or spacer makes little or no difference.

Related terms

• Anatomy

  Trapezium

  The most radial bone of the distal carpal row, articulating with the first metacarpal at the trapeziometacarpal joint. Forms the radial wall of the carpal tunnel together with the scaphoid.

• Treatment

  Ligament reconstruction and tendon interposition

  An addition to trapeziectomy in which a strip of a forearm tendon is used to make a sling for the thumb metacarpal and to fill the space left by the trapezium. Trials pooled in the 2026 Cochrane review show it makes little or no difference to pain, function or complications compared with trapeziectomy alone, and complications were about 19 in 100 against 10 in 100.

• Treatment

  Thumb joint replacement

  Replacement of the worn thumb-base joint with a small ball-and-socket implant, keeping the thumb at its full length. Compared with trapeziectomy in randomised trials it gives similar pain relief and hand-function scores, faster recovery and a stronger pinch, with a risk of implant loosening, dislocation or wear; ten-year results for modern dual-mobility designs are not yet available.

Articles mentioning this term

1. Patient information · 26 September 2026

   Thumb-base arthritis

   Thumb-base (CMC) arthritis: symptoms, splints, exercises, injections, and how trapeziectomy compares with joint replacement in recovery, strength and risk.

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