BIO: Orthopedics Now
Dr. Bertrand Perey is currently in active practice at the Royal Columbian Hospital and Eagle Ridge Hospital in the Fraser Health Authority of British Columbia. The focus of his practice is hand, wrist and elbow surgery.
He is Chief of Surgery and Head of the Division of Orthopaedics at the Royal Columbian Hospital and currently serves as a consultant in hand surgery to WorkSafe BC.
Dr. Perey is affiliated with the University of British Columbia as a Clinical Associate Professor. He is actively involved in teaching at both the undergraduate and post-graduate levels. He is a member of the Residency Program Committee and is actively involved in hand and upper extremity surgery training for the residents of this program.
Dr. Perey is a graduate of Dalhousie University Faculty of Medicine (1986) and completed his residency training in orthopaedic surgery at the University of British Columbia in 1995.
After completing a one-year fellowship in hand surgery at the University of British Columbia in 1996, he performed a second-year fellowship in hand, wrist, and elbow surgery and upper extremity reconstruction at Harvard University in Boston, MA, under the mentorship of the world-renowned Dr. Jesse Jupiter.
Dr. Perey is a fellow of the Royal College of Surgeons of Canada and a Diplomat of the American Board of Orthopaedic Surgery. He is a member of the Canadian Orthopaedic Association, and past section head for hand, wrist and elbow surgery and the annual association meeting. In addition, he is a past president and founding member of the British Columbia Hand Society. Dr. Perey was previously the hand surgeon for the BC Lions. Now Health Network
Symptoms from arthritis at the base of the thumb usually come on slowly, although some patients experience it rather abruptly.
They may be doing an activity that causes some impact in the thumb, they may fall onto their thumb, and all of a sudden their thumb is sore, only to see their doctor and be given a diagnosis of arthritis.
It’s probably been there for years and was probably asymptomatic. But usually it’s a slow onset that gets worse over time. Patients experience this as described merely with pinching activities, and eventually it becomes intolerable.
This is a point where you may get referred to either a therapist to make an appropriate brace for you, because bracing does help.
You can treat this with anti-inflammatories, and some doctors like to administer injections into the joint. Ultimately, if it because unmanageable with these vitalities, surgery is recommended.
The most common operation for arthritis at the base of the thumb involves removing a bone. The bone is a trapezium. This is a bone that’s at the bottom of the thumb metacarpal.
If you excise this bone, there’s no longer a bone for the metacarpal to rub against. The problem is you need to do something else to suspend that bone so it doesn’t collapse against the next bone in the wrist.
So usually a ligament reconstruction is added to that, and a classic operation is called an LRTI, which stands for ligament reconstruction and tendon into position, because some doctors will use a piece of tendon to put into the space created by the excised trapezium.
By and large, the operation’s a day care procedure that takes up to an hour, but most patients usually need either splinting or casting of their thumb for approximately six weeks after surgery to allow these ligaments to heal.
Once the cast is removed after your surgery for arthritis at the base of the thumb, the thumb is usually very stiff for many months. Some patients prefer to go to physiotherapy to get adequate help to regain their motion.
The overwhelming majority of patients, however, obtain complete pain relief from their surgery. Some patients may notice a bit of stiffness, and some may notice a bit of pinch weakness ultimately, but it’s rarely a functional problem.
If you think you may have arthritis at the base of the thumb, you should seek attention from your family physician, who may refer you to a specialist with expertise in hand surgery. Most of these surgeons are either plastic or orthopedic surgeons.
Local Practitioners: Orthopaedic Surgeon