Thumb CMC Arthroplasty (LRTI)


 Postop Protocol



I.Thumb Spica cast for 4 weeks

            A.Pin removed if needed (rarely use pin)



II.4 weeks

            A.Start ROM, make removal thumb spica splint

            B.Modify if MP joint capsulodesis or fusion

            C.Thumb metacarpal abduction and extention

            D.AVOID metacarpal flexion and adduction

            E.Active MP & IP joint motion while supporting metacarpal

            F.Wear splint at all times except washing and excercises



III.6  weeks

            A.Thenar strengthening (abduction, palmar & radial)

                        1.Continue for 4-6 months post operative



IV.8 weeks

            A.Begin grip & pinch strengthening

            B.Continue thenar strengthening

            C.Splinting continued until full ROM and strength functional


V.Strength and function improve for 6-12 months