Hello all,

I'm happy to have found this forum given that I was recently diagnosed with DD. My apologies for the following account of my recent surgical experience, but I'm using this forum to record the events as well as see if anyone can offer advice.

A week ago Tuesday, in my post-surgical visit with my surgeon, I was told the pathology from the biopsy came back as DD. I went into the surgery a week earlier with the diagnosis of Ganglion Cysts on both my index fingers, which my family doctor and, in turn, my hand surgeon confirmed. I'm right-handed, had the largest pad on that hand and a small nodule directly underneath. What was supposed to be smaller incisions for cysts turned out to be 1" incisions for the knuckle pad and the nodule. At my post-surgical visit, the surgeon looked at the incisions, told me what the biopsy report stated and handed me a tiny brochure on DD. Of course, I was taken aback and not prepared with any questions concerning DD. She left the room, her nurse came in, put 2 band aids on the incisions and handed me a rubber ball to squeeze. She said it would help me get mobility back in my finger and followed that with a "well some of the mobility." I asked about how to dress the incisions going forward and the nurse said, "oh, you'll figure what works best for you." She told me I could get the finger wet in the shower, but not to soak it. She then took my blood pressure and sent me home. I see the surgeon again next month. At this point, I'm 2.5 weeks into recovery after the surgery and have some questions about recovery.

- It will be 3 weeks this Monday since surgery and I still experience sharp, piercing pain at the joint with the incisions. My tolerance for pain is a 5 out of 10 while this pain is enough to make me wince and stop whatever I'm doing. To me, it almost feels like something is tearing apart underneath the surface. Is this normal at this point?

- I'm dressing only the affected finger at this point with gauze and tape. At night, while I'm watching TV, I take the dressing off and let the incisions breath. At bedtime, I wrap the index finger together with my middle finger to protect it while sleep. Is this proper care of my incisions?

- The incisions are scabbing nicely as far as I can tell, but the top incision is separating a little towards my hand as it scabs. Is this of any concern?

- My work as an engineer requires that I work at a computer for long hours. This obviously requires a lot of use of the mouse and typing on the keyboard. I also spend a couple of days a week taking hand written field notes. Is this good therapy or something I should be careful about overdoing?

- I'm trying to squeeze the ball as much as possible for therapy, however, when I'm experiencing the sharpest pains with any regularity, I leave it alone. How much should I be using the ball?

- With the negative way the nurse expressed the prognosis of future mobility of the finger, what am I to expect?

- I try to be active and I love to fly fish, tie flies, play my guitar, play the drums, play tennis, etc. I understand that it may be hard to make a fist with my right hand now. This would not be acceptable with my left hand as my guitar playing seems be what would be most affected as I could not bend my fingers to hold a chord. Now that we know what the diagnosis is based on the pathology, what are my options for the knuckle pad on the opposite index finger?

That's all for now folks. I'll likely update this post with any other questions I have. Best to everyone.

Sam

Edited 03/25/16 13:51

Welcome to forum Sam

Your post is a bit puzzling, it doesn't sound as if you had surgery for DD, but surgery for the excision of cysts and knuckle pads. Then a biopsy of the cysts have been confirmed as DD nodules. This is quite unusual practice, and dare I suggest the surgeon was perhaps not the most experienced. I also never heard of a definitive test on biopsy for DD.

Even so... recovery after many types of hand surgery can take a while. The hand is packed full of complex structures, and it's difficult to say from your description what was disturbed. I do think 3 weeks after surgery is early, so you should keep up the recommended exercises. Look out for signs of infection, new swelling, use a combination of heat before exercise, and oil to keep the scars soft. If I was in your position I would seek help from a hand clinic, a group of nurses, doctors and physio's that specialise in hands and ask for their post surgery advice. But 3 weeks is early post surgery hand recovery.

In the meantime check out the background and experience of the surgeon.

Best wishes
SB

I f it were me, I would be concerned with why the two doctors involved were not able to properly diagnose DD, most hand specialists are familiar with DD and it's symptoms. It is common for any hand trauma-surgery, injury, stress-to trigger aggressive growth of cords and nodules where they would otherwise progress slowly. I hope that is not going to happen in your case. I would find a competent hand specialist familiar with Duypuytrens and all the different remedial practices for it.

Sorry to hear the surgeon and nurse were of little help to answer all your questions . Very typical I should add from my experience. My surgeon had done surgery on pinky a slight bend knowing full well it was DD stating he must do surgery now before it becomes worse. After two months two fingers contracted to my fist despite hand therapy. When he saw the final results hand contorted and 2 fingers totally stuck at the Palm in a fist position, he said well you have had a flair, spinned around on his heels and left the room. Left no further referrals,nothing. I found Xiaflex on my own and a DD specialist,and two years later fingers are open. However the damage done by the first surgeon was totally done thru the doctors ignorance of DD.
In my case surgery for a small contracture caused a huge flair. DD has a Keobner Effect when disturbed thru injury or surgery. This can cause more collagen build up in the facia tissues and thickening of cords in the palm, as well as nodes swelling.
Thru my experience heeling takes time and it's a wait and see approach at this point in your case. There are really no cut and clear answers to your question. I wish I could answer all your questions. On a positive note keep an eye on things and see a DD specialist now for better info once the hand is examined by another dr. Sometimes its best to let the hand rest.
You are wise to do therapy and pay close attention if you see any changes or contraction of fingers, look for nodes in the palm etc.
Cysts and Spurs are quite painful. It's important in your case to take care of your hand for future use per your interests.
Heeling thoughts sent ur way!