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Post surgery advice
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12/26/2014 20:57
Rdevin 
12/26/2014 20:57
Rdevin 
Post surgery advice

I have recently had (8 weeks ago) surgery on the little finger which was at about 120 degrees.

It took nearly 4 weeks to heal and a further 4 weeks before the bandages could be left off. Its is still very swollen around the 3rd and 4th knuckle and the scar is hard inside the hand. It is very hard and stops the hand from closing, almost feels like a solid bar inside the scar which runs from half way up the finger and all the way across the palm.

Is it usual to get this hardness and any ideas of how long it lasts and what is it.

Trying some basic exercises like opening the hand and gentle stretching plus making a fist as best I can and working it with the other hand but the little finger goes from 10 to about 90 degrees only.

Is there some sort of oil or cream that can rubbed on the scar to help soften this hardness inside?

Any suggestions about therapy welcomed and other users experiences.

Many thanks

RD

12/27/2014 08:13
spanishbuddha 

Administrator

12/27/2014 08:13
spanishbuddha 

Administrator

Re: Post surgery advice

A quick browse back of old posts, I find there have been suggestions for keeping the scar moist and soft by using various emollients, ones mentioned were Vitamin E oil, and Aveeno lotion. Need to start doing this as soon as stitches are out. Other suggestions were hot water soaks with gentle stretches and fist curls. Some people take 3-18 months of PT to regain function so patience and persistence. Scar reduction with silica sheets and bio oil has been mentioned recently. Good luck.

12/27/2014 12:13
wach 

Administrator

12/27/2014 12:13
wach 

Administrator

Re: Post surgery advice

I had surgery myself and couldn't actively make a fist for about 4 months. It took 6 months until the swelling was completely gone. I am not sure to what extent physio actually helped improving the status, at least it gave me a feeling that something was done. I believe that moving your finger regularly and not aggressively will eventually improve your hand function.

You are decsribing the scar as a bar that stops bending your finger and that suggests treating the scar tissue to make it more flexible. Soaking in warm water and moderate massaging with oil, as suggested by SB, might help. There are also specific scar creams that are meant to make scars more flexible, Contractubex is an example, but I am not sure whether there is enough evidence for its effectiveness. You might ask you doctor about it. My own scars never became something like a "normal" hand tissue. Today, more than 15 years after surgery, the scars are still giving me a strange feeling in the palm and a little blockage when making a fist. But you get used to that and I am considering my surgery a success.

Wolfgang

12/28/2014 21:16
Rdevin 
12/28/2014 21:16
Rdevin 
Re: Post surgery advice

Many thanks SB and wach for the comments. We do not have PT available here so it is very much a DIY physio based on research from sites like this and advice from those who have been there before.

Your comments confirm what I was thinking which means it is probably the right direction to go.

I will try and some creams/oil from the local chemist and see how that works. The skin seems to have healed fairly well from the outside but the scar is inside the surgical line and the bar or very hard inside si so hard it stops any attempt to make a fist but I work it as much as seems plausible without pushing into pain.

From the swelling and scar tissue I assume that it was a fairly major surgery so sounds like many months will be needed.

I have also seen people discussing night splints to try and straighten the finger by gentle stretching? Any idea what the splint is - a lollipop stick and some bandage or something more advanced.

Best

RD

12/29/2014 08:08
spanishbuddha 

Administrator

12/29/2014 08:08
spanishbuddha 

Administrator

Re: Post surgery advice

The splints are usually made from thermoplastic that can be shaped in hot water. They are mostly static splints so no spring forces pushing the finger straight, but dynamic splints are also available and sometimes used. Special gloves are also available.


Simple splint photo and link to glove here http://www.dupuytren-online.info/NA_side_effects.html

Some people posted photos of their splints here http://www.dupuytren-online.info/Forum_E...ojo-0_1411.html

Just Google ' dynamic finger extension splint' to see what the sprung ones look like.

Strange you have no PT, the splints are usually made by them. Also the surgeon should be doing follow up care and advice.

I think the evidence is not significant about the benefits of splinting, but am not sure of this. Wach will know.

01/16/2015 22:56
Rdevin 
01/16/2015 22:56
Rdevin 
Re: Post surgery advice

Have been trying the warm water soaks and oil massages plus cool packs and it seems to keep the hand about the same, if I stop the procedure for 2 or 3 days then it stiffens quite quickly so have to assume it is doing something.

Having done much research I found a lot on 'flare reaction' which describes well what I seem to have, swollen hands and stiff wrist and finger joints, why it occurs is less obvious as is the best way to improve it.

Reading the link that SB posted in another thread (http://www.dupuytrens.me.uk/dupuytrens.html) it does cover much of the background to the problem and explains well the reasons why various collagen types are formed and what they do in the healing process and what they can also do to hand in general especially if excess collagen is produced. If DD does indeed thrive on collagen then trying to ensure as little as possible is produced/available seems very logical indeed.

The article is very informative and would or should be essential reading for anyone contemplating surgery

it is also interesting to note his own experience with his left hand is pretty similar to mine - bit (to very) worrying really.

It is better in some respects that one does not stick ones little finger in places it does not belong during everyday life but then again barely being able to make a fist to hold a can of beer is maybe a poor trade off.

RD

04/23/2015 09:10
bessymarf 
04/23/2015 09:10
bessymarf 
Re: Post surgery advice

Before applying any cream for this kind of skin related issues we must clean up the skin with water and later apply a scar reduce creams. While doing this regularly without fail you can get the best results.

04/23/2015 21:29
Cherise 
04/23/2015 21:29
Cherise 

Re: Post surgery advice

After surgery all my fingers curled when I only had one pinky finger contracting. Surgery can cause a flare withe the fingers & hands as in my case.

After this I had Xiaflex injection to open up the pinky that went from a slight curve to a close fisted 135' position and a thickened scar. Xiaflex injection opened my pinky and also eliminated the thick scar tissue.

Xiaflex a bio drug. It's a enzyme that breaks thru the thickened collagen tissue that causes the contraction and since scar tissue is made up of collagen, the scar from the origional surgery is gone. The surgeon then opened my pinky finger to a straight position after a weeks time from the Xiaflex injection. Also wear a finger splint nightly.

My experience with both treatments is different, as everyone does react differently to treatments for DC.
Please consult a DC specialist experienced with Xiaflex before you try surgery.

04/23/2015 22:02
BRIANB 
04/23/2015 22:02
BRIANB 
Re: Post surgery advice

Who did the injections ... and who was the surgeon ?

04/23/2015 22:05
BRIANB 
04/23/2015 22:05
BRIANB 
Re: Post surgery advice

I always wonder if any hand surgeons follow this forum ... because there are many that want to do one thing.... and that is surgery ... even though it can create many problems in some cases..

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