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OA of the base of the thumb is a very common complaint. Tis is usually due to normal wear and tear, caused by the demands placed on the thumb during everyday activities.

OA at the base of the thumb can cause symptoms of pain and stiffness. You may find some difficulty with gripping and tasks such as opening jars and turning a key in the lock.

Symptoms can often be controlled by non surgical treatments but if they are not effective surgery may be an option. The most common surgery is called a trapeziectomy. Here, we will give you some advice after having a trapeziectomy.

The surgery is generally a day procedure which means you can usually go home on the same day as your surgery. Depending on the procedure it may be performed under local anaesthetic in which you will remain awake or under general anaesthetic in which case you will be asleep.

The surgery involves removing a small bone called the trapezium through a small cut at the base of your thumb.

Removal of this bone gives more space for the thumb to move so that the bone surfaces are not rubbing together causing pain.

Sometimes an additional small cut is made on the front of your forearm in order to get a piece of tendon to use to stabilise the base of the thumb after the small bone is removed.

Please note that as with any surgery there are potential risks involved. The majority of people have straight forward recovery following surgery. However complications can occur and include:

• Infection
• Nerve damage causing altered sensation or loss of feeling in the thumb area.
• Persistent scar tenderness.
• Injury to the arteries of the finger or hand.
• Failure to resolve the pain.

Please contact the clinic on the numbers provided if you have any concerns

Your thumb and hand will be put in a splint or a cast. Your surgeon will advise on when the cast or splint will be removed or changed but this is usually for an overall period of 6 weeks.

If a wire has been inserted, this can be removed after 3 to 4 weeks.

During the time your splint or cast is on, it is important to:

• Keep your hand raised to help get rid of swelling
• Move your fingers to prevent them from becoming stiff
• Do not use your hand for anything other than very light functional activities (eg using telephone, finger typing, turning on a switch)
• Do not drive

You may experience pain and discomfort at first but normally this resolves with time. Please speak to your GP or pharmacist about controlling your pain if necessary.

After the splint or cast has been removed at around 6 weeks after your operation you can now start to exercise your thumb. The exercises are described below. You should try to use your hand as normally as possible but avoid heavy lifting or prolonged tight gripping until around 10 to 12 weeks after the operation. How much you are able to do with your hand at this stage depends on how much pain you are experiencing. it is important to manage your pain to allow you to move your thumb and do your exercises.

Exercise 1

Hold all fingers straight. Make big circles with your thumb. Repeat 10 times.

Exercise 2

Place the back of your hand on a table with your thumb and fingers rested. Bring your thumb across to the base of your little finger as far as you are able. Return your thumb back to the starting position. Repeat 10 times.

Exercise 3

1. Place your elbow or back of your hand on a table. Put the tip of your thumb against each of your fingertips in turn. Repeat 10 times.
2. Practice picking up small objects.

Exercise 4

Bend the upper joint of your thumb. Assist the movement with your other hand. Hold for 15 seconds. Repeat 10 times.

You can return to driving when your cast or splint has been removed finally (usually around 6 weeks after your operation) and it is comfortable and safe for you to do so. You must feel that you are in complete control of the car; it is your responsibility to check with your insurance company before returning to driving.

Time Off Work

This will depend on your occupation, place of work, ability to return to light duties and may at times be dependent on whether the operation has been carried out on your dominant hand or not.

Please remember that recovery of full function can take a long time, in some cases it can be 6 months or more before you can carryout any heavy functional tasks.

A knee arthroscopy is a common orthopaedic operation which involves looking into the knee joint with a fine telescope. It allows the surgeon to see inside the knee and treat several conditions. It is performed under a general anaesthetic, which means that you will be asleep throughout the procedure.

Preparing for Your Appointment

• Please see your day surgery appointment and guide booklet for further instructions. It is important that you read and follow these instructions fully.
• Please wear loose fitting trousers, e.g. track suit bottoms as you will have a bulky bandage on your knee after your surgery.
• Do not shave your knee.

• You can expect some discomfort around the wound area. The painkiller tablets given to you before going home should help. We will advise you how to take these. Within the first 24-48 hours, if you have severe pain in your knee not relieved by the painkillers or if your knee becomes very swollen, you should seek advice.
• Do not take alcohol while taking pain killers.
• You can help to reduce pain and swelling by raising your leg several times a day and using ice over the knee for 10-15 minutes. (It is important to wrap the ice in a damp towel to protect from ice burn)

Wound Healing

• The wounds will take approximately 1 week to heal.

Stitches

• Normally there are no skin stitches.
• Small sticky tapes have been applied.
• Please make an appointment with your GP 10 days following your surgery to have your stitches removed (if applicable).

Wound Dressing

• You may have a padded bandage on top of the dressing. Please remove the padded bandage 24 – 48 hours after your operation.
• You will have a dressing covering your wound. Remove the dressing after 24- 48 hours. 
• Some surgeons like you to replace the bandage with a tubigrip to proved knee support.
• The tubigrip should be worn over the knee from 3 to 4 inches above to 3 to 4 inches below the knee.
• Continue to wear the tubigrip until the swelling goes down. It should be worn all day but removed at bedtime.

Wound Care

• Do not shower or bathe for at least 24 hours after your operation.
• Bathe in plain water only, do not use perfumed products or talcum powder.
• Make sure you dry your wound gently and thoroughly.

Once home, rest as much as possible for the remainder of the day.

For the initial few days after surgery the leg should be rested and raised several times a day. It is however vital that you perform your physiotherapy exercises.

You should limit your amount of walking for the first few days and gradually build this up.

Physiotherapy

• You should not need any walking aids following your surgery; you should get up and try to walk as normally as possible.
• If you are finding stairs difficult, it may be easier, for the first few days if you take one step at a time, going up with your unoperated leg first and down with your operated leg first.

Return to Work

You can usually return to work after 24 hours but this will depend on your occupation.

Driving

• Do not drive a vehicle or ride a bicycle for a minimum of 24 hours.
• Only return to driving when able to comfortably and safely change gear and carry out an emergency stop.
• Contact your insurance company for further details; all policies vary.

 You can start doing these exercise immediately after your surgery although some people prefer to wait until the next day.

Knee Flexion / Extension

Repeat 2 to 3 sets of 10 reps of this exercise. Continue to perform this 2-3 times daily until the movement of your operated leg is equal to the other side.

Passive Knee Extension Stretch

Sitting on a chair, supporting your operated leg on a chair as shown. Let your leg straighten in this position. Remain in this position for 15 minutes to allow the knee to stretch. Slowly bend the knee to take it off the chair. This exercise will assist you to regain full straightening of the knee. Discontinue when you have regained full straightening.
Repeat 1 to 2 times daily.

Static Quadriceps Strengthening

• Sit with your leg straight. Pull your toes back and push your knee straight by tightening the muscles on the front of your
  thigh.
• Hold for 5 seconds – relax.
• Repeat 2-3 sets of 10 reps of this exercise 2-3 times daily.

Quadriceps strengthening

• Sit with a rolled up towel (or pillow) under the knee. Pulling toes up, press the back of the knee into the roll and lift the heel up by tensing the front of the thigh.
• Hold for 5 seconds – relax.
• Repeat 2 to 3 sets of 10 reps of this exercise 2 to 3 times daily.

Straight leg lift (knee strengthening)

• Sit with your operated leg straight. Exercise your straight leg by pulling the toes up, keeping the knee straight and lifting the leg off the bed.
• Hold approx. 5 secs – slowly lower.
• Repeat 2-3 sets of 10 reps of this exercise 2-3 times daily.

Progress onto this exercise when you are able to do it pain free after surgery. This may take up to 6 weeks.

Step up

• Stand in front of a step. Lead with the operated leg and step fully up onto it.  Use your operated leg to lower yourself back down and start again.
• Repeat 10-30 times as able, repeat on the other side.
• Aim to do the same on each side. Do this 2-3 times daily.
  

Follow Up Clinic

• For most patients there is no need for you to return to the Orthopaedic clinic after your surgery.
• However, if 6-8 weeks following you operation you have any concerns regarding your knee, see contact details.

Passing Urine

• It is important that you pass urine as normal after day surgery.
• Sometimes there may be a delay because you have been fasting. If you have not passed urine before leaving day surgery then you should continue to drink plenty of fluids.
• After several hours at home if you still do not pass urine, or have an urge but are unable to do so, seek advice.
  See contact details.

First Aid

• Slight oozing of blood from the wound is not unusual in the first 24 hours.
• If the wound bleeds heavily, lie down, raise the leg on a pillow and apply pressure with your hand for 10 minutes.

Seek advice immediately, using the contact details, if you develop:

• Persistent bleeding
• Severe bruising or swelling
• A high temperature
• A hot red wound
• A foul smell from the wound

GP Letter

You will be given a letter for your GP.

Please hand this into your GP surgery as soon as possible to inform them of your hospital attendance.

In an emergency

In an emergency go immediately to your nearest Accident and Emergency (Take your GP letter, procedure information sheet and any tablets issued by Day Surgery).

If you have any further queries regarding your operation please contact the Day Surgery Unit where you had your operation.

New Victoria ACH (Day Surgery Unit)

• Call 0141 347 8242 8.30am – 8.00pm Monday to Friday.
• Out with these hours, if further help or advice is required, contact Ward 3, The New Victoria Hospital (0141 347 8453)
  Contact NHS 24 Telephone No: (111).

Gartnavel General Hospital (Ward 4C)

• Call 0141 211 3451 8.00am – 7.00pm Monday to Friday
• Out with these hours, if further help or advice is required, contact NHS 24 by calling 111.

Queen Elizabeth University Hospital (Ward 10A/10B)

Call 0141 452 2700 or 0141 452 2730 8.00am – 7.00pm Monday to Friday• Out with these hours, if further help or advice is required, contact NHS 24 by calling 111.

For most patients there is no need for you to return to the Orthopaedic clinic after your surgery and most patients do not need follow up physiotherapy.  

However, if 6 to 8 weeks following you operation you have any concerns regarding your knee, please contact the  physiotherapy team on 0141 211 3452. This phone is not always attended, we will endeavour to call you back within 2 working days.

To contact the Maternal and Child Public Health Team please e-mail Emma.Kinghorn2@nhs.scot

• 20 Apr 2016 Starting life smoke-free in NHSGGC
  A health needs assessment of infants exposed to tobacco smoke in pregnancy and the first year of life.
• 31 Dec 2015 Maternity booking appointment survey 2015
  Key findings report
• 1 Apr 2015 “Ready to learn” (30 month) assessment first full year data report: July 2013 – July 2014
  The report presents the key findings from the 1st year of Ready to Learn (27-30 month) assessments conducted in NHS Greater Glasgow and Clyde.
• 29 Jan 2013 Healthy Mums Healthy Children:Report on the health of pregnant women and children 2011/12
  This report describes the ways in which health services were delivered for the population of children and pregnant women resident within the NHS Greater Glasgow and Clyde Board area, and provides a basis for action in order to deliver safe, effective, high quality care in a way which seeks to reduce inequalities in health. For more information, please contact ggc.phsuadmin.admin@nhs.scot.

• 2 Oct 2019 Healthy families healthy children information pathway
  The Healthy Families, Healthy Children Information Pathway has been designed to assist NHS Greater Glasgow and Clyde staff who work with pregnant women, families and children. It identifies publications which are available to support effective communication with parents and carers to improve maternal and child health outcomes.
• 17 May 2018 Reducing Sudden Unexpected Death in infants in NHS Greater Glasgow & Clyde
  Reducing Sudden Unexpected Death in Infants in NHS Greater Glasgow & Clyde – an information pathway for staff

The Child Poverty (Scotland) Act 2017 places a duty on local authorities and regional health boards in Scotland to produce annual Local Child Poverty Action Reports (LCPARs) describing ongoing and planned action to tackle child poverty at local level. National guidance suggests that the LCPARs be developed collaboratively with local partners and that they bring about a ‘step change’ in action to tackle child poverty.

Local Child Poverty Action Reports 2020/21

• Glasgow City
• East Dunbartonshire
• West Dunbartonshire
• East Renfrewshire
• Renfrewshire
• Inverclyde

The first round of Local Child Poverty Action Reports were published in June 2019 and are available below.

Local Child Poverty Action Reports

• Glasgow City
• East Dunbartonshire
• West Dunbartonshire
• East Renfrewshire
• Renfrewshire
• Inverclyde

Local Child Poverty Action Reports Website Links

• Glasgow City
• East Dunbartonshire
• West Dunbartonshire
• East Renfrewshire
• Renfrewshire
• Inverclyde

Useful Resources and Websites

• Child Poverty Action Group
• Tackling child poverty: first year progress report (2018 to 2019)
• Glasgow Centre for Population Health  –  Family and Child Poverty
• Glasgow Centre for Population Health –  Children and Young People’s Health and Wellbeing Profiles
• Improvement Service –  Local Child Poverty Action Reports
• NHS Health Scotland –  Child Poverty
• Scottish Public Health Observatory –  Child Poverty 
• Poverty and Inequality Commission

The Podiatry Service offers an innovative and soundly governed Practice Based Learning (PrBL) programme. We utilize a blended learning provision which is centred on a Peer Assisted Learning (PAL) model. We aim to engage students in a programme of meaningful clinical thinking with the objective of maximising their capabilities and confidence within clinical decision making whilst delivering optimal person centred care.  

Over the course of an academic year, we offer in excess of one thousand placement weeks. Placements are offered to both institutes in Scotland offering entry qualifications into Podiatry. There are currently two institutions offering Podiatry, Glasgow Caledonian University (GCU) and Queen Margaret University . Various options of study are available depending upon eligibility criteria being met.

As the primary PrBL provider for the GCU Podiatry programme, we host Level 1 to Level 4 students at the Department of Podiatry, Queen Elizabeth University Hospital (QEUH) throughout Trimester A and Trimester B which acts as our placement hub. Block placements occur during Trimester A, B and C within the single service seperate from our placement hub. 

Additionally, as the need for PrBL placements for all AHP professions increase, we aim to explore new and innovative methods of offering cross-profession PrBL opportunities through both face-to-face and digital platforms.  

The Podiatry Service works collaboratively with its academic colleagues ensuring alignment to learning outcomes with quality underpinning every placement hour. 

We are keen to hear the voice of the student and their experience at the end of each placement. Using a student-based audit enables an understanding of what worked and what didn’t to inform changes to the PrBL programme. 

Are you thinking about studying Podiatry and want to find out more? Consider joining our ‘Get Ready For’ programme.

The Podiatry service offers an excellent opportunity for podiatrists who wish to return to podiatry practice and require to re-register with the Health and Care Professionals Council (HCPC). Our fully funded learning programme will support you in your return to practice. Candidates who successfully achieve registration will be eligible to apply for Band 5 posts within NHS Boards.

We offer a structured development opportunity to support and consolidate knowledge, skills and competence in supportive learning environments. Your individual learning and support framework will have full mentorship from our team of practice educators and practice development.

In this post you will:

• Have the opportunity to provide podiatric care in a variety of clinical environments. You will be supported by your mentor using various supervisory methods.
• Provide a high level of both palliative and corrective care as outlined in the agreed management plan.
• Liaise with or referring to other Health Care Professionals (HCPs) or Agencies as appropriate.
• Plan and organise own workload to ensure effective caseload management of a diverse range of patients

Knowledge, Experience and Qualifications

You must hold a BSc (Hons) Podiatry or Diploma in Podiatry and will be required to complete a period of supervised practice. The length of supervised practice will be detailed by the HCPC Returning to Practice Requirements. You will demonstrate the ability to work as part of a team. Evidence of prioritisation, planning and organisation of workload are essential.

Roles and Responsibilities

You will create a portfolio to showcase your learning and development.

Adapt your learning needs through reflective practice and feedback to develop professional knowledge and skills.

Read and understand the HCPC Standards of Proficiency.

We offer this opportunity on a fixed term basis and will accommodate the return to practice requirement of the applicant. There is flexibility across whole and part time working.

For initial discussion please contact Julie Braidwood on Julie.Braidwood@nhs.scot or Pamela Price on Pamela.Price@nhs.scot

What is PREPARE?

The Pre Registration Podiatry: Accessible Recruitment & Employment (PREPARE) Project is an innovative approach to growing our workforce by enabling people into the profession of Podiatry. The service employs PREPARE trainees on an annex 21 basis to undertake a BSc (Hons) in Podiatry. PREPARE Trainees receive full employee benefits as per Agenda for Change terms and conditions. 

How does PREPARE work?

The Podiatry Service has an agreement with Glasgow Caledonian University (GCU) which has condensed the teaching timetable to three full days, instead of spreading it over five days. This is in line with student feedback across the institution and would benefit the student experience. There is no change to programme or module learning outcomes. PREPARE Trainees have dedicated time to engage within the academic content up to 3 days per week with the remaining 2 days being specified by service led duties. Trainees engage in service-led duties 5 days per week during non term time.  

Why is PREPARE needed?

Through widening access to those who are not able to leave full time employment to access adult learning opportunities we believe this novel approach to meeting the workforce challenges stands to safeguard frontline Podiatry services in NHSGGC for the intermediate and long term future. Investment in ‘Earn to Learn’ schemes enhance graduate capability by providing integration across service delivery which enables extensive clinical exposure, whilst undertaking graduate level study. 

Continuation of employment to a Band 5 Podiatrist is subject to successful completion of the BSc (Hons) Podiatry and Health & Care Profession Council (HCPC) registration. For the Health Board, these graduates will have extensive clinical experience, alongside a detailed knowledge of policies and procedures. The Podiatry service will employ PREPARE to 4 trainees per academic year from 2023 to 2027. 

What Next?

Are you thinking about studying Podiatry and want to find out more? Consider joining our ‘Get Ready For’ programme.

Hear from a PREPARE Trainee and their experience in the video below.