A fracture at the very base of the thumb runs into the joint and has a muscle pulling it out of place, which is why it usually needs fixing rather than casting. The goal is a smooth joint surface, not just a healed bone.
Trapeziectomy removes the arthritic bone at the thumb base, and the pain relief is reliable. Strength is the slow half: pinch often measures worse at 3 months than before surgery, which is normal. The honest verdict sits at month 9 to 12.
Skier’s thumb is a torn UCL ligament at the thumb knuckle, and a complete tear often cannot heal on its own because tissue slips into the gap. The repair window is weeks. A “sprained thumb” with weak pinch needs assessment this week.
Thumb base (CMC) arthritis is the most common hand arthritis: a deep ache that flares with every pinch. It’s about management, not cure, and managed early most thumbs stay functional for years. The alarm isn’t pain level. It’s avoidance.