Home > Blog > Hand Therapy & Customized Splinting > Conditions > Finger, Hand, Wrist, Forearm & Elbow Conditions > Ligament Reconstruction Tendon Interposition Procedure Hand Therapy

Ligament Reconstruction Tendon Interposition Procedure Hand Therapy

“Working with a knowledgeable hand therapist can make the difference between success and failure in complex hand surgical cases. The therapist extends the continuum of our care, as well as functioning as coach and trainer for our patients.”

Marybeth Ezaki, MD, Past President, American Society for Surgery of the Hand

In Phoenix Rehab, our senior hand therapists are experienced licensed and dedicated therapists (physiotherapists and/or occupational therapists) who specialized ONLY in the rehabilitation, treatment and management of painful fingers, hands, wrists, forearm & elbow conditions, because of interest, passion and expertise.

Area of arthritis at the base of the thumb

Arthritis at the base of the thumb is also known as CMC (carpal metacarpal) arthritis, or basal joint arthritis. This specific arthritis causes pain at the base of the thumb, and is typically treated with

  • rest
  • inflammation / pain killers medicine or
  • use of a thumb orthosis for support

That being said, if the thumb pain continues, your doctor may recommend surgery.

There are many different types of surgery that treat this type of thumb pain and a specific surgery is called a ligament reconstruction tendon interposition procedure (LRTI).

What is done during an LRTI procedure?

During surgery, the arthritic parts of the bone at the base of the thumb are removed.

  • A small cut in the forearm is then made to get a tendon that will be rolled up and used to fill the space at the base of the thumb
  • Now the bone in the thumb will not rest on the piece of bone that was causing the thumb pain
  • Part of the tendon from the forearm is also used to rebuild the ligament that provided support to the thumb
  • Removing the tendon to use for this surgery will not affect wrist motion or strength.

If arthritis pain at the base of the thumb is present after non-surgical treatment, an LRTI procedure may be recommended

What should I expect after surgery?

After surgery, the wrist and thumb will be immobilized in a cast or orthosis. 

It is important to keep the hand above the heart to limit any swelling.  It is also important to move the shoulder, elbow and fingers to prevent joint stiffness and help with swelling.

The wrist and thumb will be immobilized until your doctor gives our senior hand therapist and you the green light and instructs you to begin exercising them. 

After surgery, the doctor will refer you to our senior hand therapist to assist in recovering full function, movement and strength of your thumb and hand.

What can a hand therapist do for me?

Our senior hand therapist can assist in care after surgery.

We can make a custom thumb splint and demonstrate exercises to increase range of motion and strength. We can also teach you how to take care of your scar and recommend ways to limit the force you put on your healing thumb.

An extended number of hand therapy sessions may be needed to help regain functional use of your wrist and hand.

Example of custom orthosis for wrist and thumb following an Ligament Reconstruction Tendon Interposition Procedure

Patients may also receive the following hand therapy treatment modalities: