CMC Arthroplasty — Thumb CMC Arthroplasty — LRTI

University of Virginia Orthopaedic Surgery

Weight-Bearing

NWB surgical UE

Key Restrictions

No lifting/pushing/pulling; grip/pinch with minimal to no resistance; orthosis protection for functional activities; cast 2-3 weeks then HFO or WHFO until 10 weeks; may remove for light self-care from week 8

Timeline & Phases

Phase 1 (0-2 wks): thumb spica splint; Phase 2 (2-10 wks): cast 2-3 weeks then HFO short opponens or WHFO thumb spica, wrist/forearm AROM, thumb CMC/MCP neuromuscular retraining (C's and O's), joint blocking, dexterity, radial nerve glides if SSRN hypersensitivity; Phase 3 (10-12 wks): wean orthosis, progressive wrist strengthening, continued neuromuscular reeducation

Notes

LRTI = Ligament Reconstruction Tendon Interposition; neuromuscular retraining for balanced pinch (C's and O's) and first dorsal interosseous; manual thumb adductor release; SSRN hypersensitivity monitoring; joint conservation education; long-term Comfort Cool CMC orthosis recommended PRN for soft tissue rest

Published

09/2024