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Artroplastia da articulação do polegar

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Updated May 2026
Uma ilustração desenhada à mão de uma mão fazendo uma pinça confortável entre o polegar e o dedo.
Raio X após uma artroplastia do polegar Touch: um pequeno implante de dupla mobilidade recobre a articulação entre o trapézio e o metacarpiano do polegar — a articulação que se desgasta na artrose basal do polegar. Kieran Hirpara 4.0

Esta página foi traduzida automaticamente e ainda não foi verificada por um médico. A versão em inglês é a versão oficial.

Por que esta cirurgia foi sugerida

Seu cirurgião provavelmente sugeriu esta substituição da articulação do polegar porque a osteoartrite por desgaste na base do seu polegar não melhorou o suficiente com os tratamentos não cirúrgicos. Esta cirurgia é geralmente oferecida quando as atividades diárias se tornam dolorosas e difíceis. O objetivo é remover as superfícies articulares danificadas e substituí-las por um novo implante para restaurar o movimento.

Este procedimento visa proporcionar baixos níveis de dor, excelente mobilidade e alta satisfação. Ao substituir a articulação desgastada, você pode recuperar a força e o comprimento natural do seu polegar. Seu cirurgião pode recomendar esta abordagem específica para garantir que a nova articulação dure o máximo possível enquanto você retorna à sua vida normal.

Antes da cirurgia

Você precisará jejuar antes da sua cirurgia e suspender certos medicamentos conforme orientado pelo seu cirurgião. Por favor, organize um transporte para ir para casa e traga uma lista de todos os medicamentos atuais. Pode ser necessário realizar radiografias, exames de sangue ou uma avaliação anestésica para garantir que você esteja preparado. Seu cirurgião fará um único corte sobre o seu polegar para realizar o procedimento. Você não deve dirigir enquanto usar a tala para o polegar por quatro a seis semanas. Esta tala impede que você segure o volante com segurança. Você só poderá dirigir novamente após a remoção da tala e com a liberação do seu cirurgião. Consulte Dirigir após cirurgia de membro superior para mais detalhes.

No dia da cirurgia

Você chega ao hospital e encontra o seu anestesiologista antes de ser levado ao centro cirúrgico. Esta cirurgia é realizada sob anestesia geral. Você ficará completamente adormecido durante o procedimento. Alguns pacientes também podem receber um bloqueio nervoso regional para alívio da dor pós-operatória; o anestesiologista decide no dia da cirurgia, com base nas suas condições individuais. O seu cirurgião faz um único corte convencional sobre o seu polegar para realizar o procedimento. Ao despertar na sala de recuperação, você terá um talabarte (órtese) na mão.

Você não pode dirigir enquanto estiver usando este talabarte de polegar. O talabarte impede que você segure o volante com segurança. Você deve esperar até que o talabarte seja removido e o seu cirurgião autorize você a dirigir novamente. Consulte nosso guia sobre dirigir após cirurgias do membro superior para mais detalhes.

O que a cirurgia envolve

O seu cirurgião fará um único corte na base do seu polegar. Esta abordagem aberta proporciona acesso claro à articulação. No interior, o cirurgião remove as superfícies articulares desgastadas que causam a sua dor. Estas áreas danificadas são então substituídas por novas peças de metal e plástico para criar uma articulação suave e móvel.

Para encaixar as novas peças, o seu cirurgião molda cuidadosamente o osso e pressiona a nova cúpula no lugar. Esta etapa é realizada com grande cuidado para evitar fraturar o osso ou fazer com que a nova peça se solte. Uma vez que a nova articulação esteja segura, o corte é fechado com pontos. Provavelmente, usará uma tala no polegar durante quatro a seis semanas para proteger a reparação enquanto ele cicatriza.

Não pode conduzir enquanto usa esta tala, pois ela impede que agarre o volante de forma segura. Só poderá conduzir após a remoção da tala e com a autorização do seu cirurgião. Para mais detalhes, consulte Conduzir após cirurgia do membro superior.

Após a cirurgia

Você acordará em uma enfermaria de recuperação, onde sua dor será controlada de forma suave. Seu polegar será envolto em curativo e colocado em uma tala. Você poderá mover os dedos imediatamente, mas deve manter o polegar imóvel. A maioria dos pacientes permanece uma noite no hospital após esta cirurgia, embora alguns possam ir para casa no mesmo dia. Alguém deve ficar com você durante as primeiras 24 horas. Esta tala permanece no lugar por quatro a seis semanas. Não dirija enquanto a tala estiver no lugar, pois você não consegue segurar o volante com segurança. Você poderá dirigir novamente após seu cirurgião remover a tala e liberá-lo.

Recuperação

Você sentirá dor e inchaço no polegar e na mão nos primeiros dias. Isso é normal. Seu cirurgião fornecerá uma tala ou gesso para proteger a articulação. Você deve usar esse dispositivo para manter o polegar seguro enquanto ele cicatriza. Não dirija enquanto a tala estiver no lugar, pois você não consegue segurar o volante com segurança. Você só poderá dirigir após a remoção da tala e com a liberação do seu cirurgião.

A vida cotidiana parecerá diferente no início. Você usará a outra mão para a maioria das tarefas, como comer ou escrever. Seu fisioterapeuta ensinará exercícios suaves para manter os dedos em movimento. Esses movimentos ajudam a reduzir a rigidez e recuperar a força. À medida que o inchaço diminui, você notará que o polegar se sentirá mais estável. Você começará gradualmente a usar a mão para atividades leves sem dor.

Sua jornada de recuperação é única para você. Algumas pessoas melhoram mais rápido, enquanto outras levam mais tempo. Seu cirurgião e fisioterapeuta o guiarão em cada etapa. Eles dirão quando for seguro retornar ao trabalho ou aos esportes. Confie no processo e ouça seu corpo enquanto você se recupera.

O que pode correr mal

A maioria dos pacientes tem uma boa evolução, mas ocasionalmente podem ocorrer problemas. O seu cirurgião e a equipa monitorizam-no de perto para detetar qualquer problema precocemente.

Pode sentir uma dor profunda e pulsátil que não melhora com analgésicos simples. Isto pode significar que o implante não está posicionado corretamente ou está a afrouxar. Se notar isto, ligue para a clínica imediatamente.

Por vezes, a articulação sente-se instável ou cede quando tenta usar a mão. Pode sentir um deslocamento súbito ou uma sensação de estalido. Informe o seu cirurgião imediatamente se isto acontecer, para que ele possa verificar a estabilidade.

Em casos raros, o revestimento de plástico no interior da articulação pode partir. Pode não conseguir ver isto numa radiografia padrão, mas pode sentir um novo atrito ou bloqueio no polegar. Mencione isto na sua próxima consulta de revisão para que o seu cirurgião possa investigar mais profundamente.

Se o osso onde o implante está assentado fraturar durante a cirurgia, pode sentir uma dor aguda ou notar um inchaço que parece desproporcional. Este é um problema grave que requer atenção cuidadosa da sua equipa cirúrgica.

O seu cirurgião também vigiará sinais de que as partes metálicas estão a esfregar demasiado umas contra as outras. Isto pode causar desgaste e levar à necessidade de outra operação mais tarde. Se a sua dor voltar ou mudar após um período de melhoria, informe-o.

A tabela de complicações nesta página lista as taxas típicas, caso queira os detalhes específicos.

Quando ligar para nós

Ligue para nós se tiver febre, vermelhidão crescente ou secreção na ferida. Procure atendimento de emergência em caso de dor intensa súbita, inchaço na panturrilha ou falta de ar. Entre em contato imediatamente se perder a sensibilidade ou não conseguir mover o polegar. Limitar cargas pesadas no polegar ajuda a prolongar a durabilidade da sua nova articulação. Seu cirurgião orientará sobre quando parar de usar a tala antes de dirigir.


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