Hand Therapy – Metacarpal Phalangeal Joint (MCPJ) Replacement

What is a metacarpal phalangeal joint (MCPJ)  replacement?

The MCP joints are the large knuckles at the base of your fingers, often referred to as ‘knuckles’. These joints enable us to position our fingers correctly during tasks as well as allowing for strong gripping and pinching.

We use our hands in this way throughout the day so these joints can wear down and become painful. Some conditions, such as rheumatoid arthritis, can also cause joint changes. A metacarpal phalangeal joint (MCPJ) replacement involves removing the old joint and replacing it with a new hinged joint.

What can I expect after surgery?

• Large cast and bandage for the first few days.
• Swelling and stiffness of the operated hand. This is normal and should reduce over time. Elevating your hand above your heart can reduce this.
• Pain can be normal immediately after surgery. Please discuss this with hand therapist.
• An appointment in Hand Therapy within one week of your surgery.

The Hand Therapist will make you one or two plastic splints depending on the reason for your surgery. The type of splint depends on the reason for your surgery and will be explained to you at your appointment.

These must be worn at all times for the first four weeks. They will also teach you some exercises at the first appointment, in order to regain the movement of your finger.

In most cases, your Hand Therapist will see you every one to two weeks to check your wound, splints and progress your exercises as needed. Usually, it takes approximately 12 weeks after surgery, to be discharged by Hand Therapy, and return to full function.

How do I care for my splints?

You will be provided with one or two plastic splints in order to protect your hand. Your Hand Therapist will guide you, as to when you can begin to remove it for daily activities.

• Keep the splints clean and dry.
• DO NOT try to make alterations to your splint.
• Keep away from sources of heat.
• You may clean the outside with baby wipes/a damp cloth.

How do I care for my scar?

The Hand Therapist will demonstrate and advise you when to start scar massage. This is normally once the wound has healed and is scabbed over. Scar massage is useful as it helps to break down the scar tissue. This allows the scar to move more freely and reduces the risk of the scar becoming sensitive.

To complete scar massage

• Use non-perfumed cream.
• Apply firm pressure in circular movements along the length of the scar.
• Complete for 5 minutes at a time at least 4 times a day.

Please do not try your own exercises as this could cause increased pain.

When can I return to normal activities?

Your hand is likely to be weak for approximately twelve weeks after the operation and care has to be taken to protect it. You will be guided by your Hand Therapist as to when you can return to normal activities. The table below gives some examples.

Do I need to take time off work?

Your Hand Therapist will discuss with you when it is appropriate to return back to your normal work and hobbies. Please speak to your G.P. if you require a fit note. The table below details when you may expect to return.

Contact Details

Please contact Hand Therapy if:

•           You have any concerns or questions.
•           If your splint is rubbing or is uncomfortable.

Contact details are:

North Tees and Hartlepool NHS Foundation Trust

Hand Therapy Team
Telephone: 01429 522 471
Monday to Friday 08:30 a.m. to 04:30 p.m.

You will be asked to attend either:

Hand Therapy

1st Floor, North Wing
University Hospital of North Tees
Hardwick Road
Stockton-On-Tees
TS19 8PE

Physiotherapy Outpatients Department

Ground Floor
University Hospital of Hartlepool
Holdforth Road
Hartlepool
TS24 9AH

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]