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Post surgery issue
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10/06/2014 18:09
emelem 
10/06/2014 18:09
emelem 
Post surgery issue

Hi,
I'm a 56 year old male with DC in both hands. Small finger PIP contractures of 90%. On September 2, 2014, I had open fasciotomy surgery on my left hand. Scar is zig-zag pattern down the shaft of my pinkie, and then a diagonal scar on my palm ending about 1 inch below my ring finger. 4 weeks into rehab, and I'm unable to make a fist. When I try, I feel a considerable amount of pressure on or compression of my median nerve. The result is numbness and tingling in my thumb and forefinger. Symptoms are best described as those experienced by people with Carpal Tunnel Syndrome. Most numbness and tingling subsides once I stop exercising, but tips of both thumb and forefinger have been numb for days. Has anybody else had a similar experience?

Someone else in the forum referred to this stage of post-op as the "omg what have I done to myself" or words to that effect. I'm in that state-of-mind at the moment.
Thanks

10/06/2014 20:15
spanishbuddha 

Administrator

10/06/2014 20:15
spanishbuddha 

Administrator

Re: Post surgery issue

Hi emelem

The experience for many having DD surgery is that recovery is best measured in months rather than weeks. Five weeks after the surgery is probably too soon to feel pessimistic about the eventual outcome. Nerve recovery and regrowth is really slow. A colleague I know had problems with swelling and numbness for up to six months, and that was for a possibly more straight forward pinkie amputation.

Users posting here advise to follow the physio exercises but don't overdo it, and keep the wound/scar supple with lotion. A consult with your surgeon is a good idea, and if your physio is experienced with working with DD patients, they may be able to offer their own thoughts.

Best wishes
SB

10/07/2014 11:34
newman 
10/07/2014 11:34
newman 

Re: Post surgery issue

Hi
Firstly don't overdo things as it is only 4 weeks since surgery. Make sure you keep you hand elevated and flex the fingers to keep the circulation going. First thing in the morning soak the hand in warm water and with the fingers outstretched gently apply downward pressure forcing the fingers on to the bowl of the hand basin. Then make a fist.
It is not unusual to have the tingling sensation . I had a nerve conduction velocity test (NEV) using an electromyography (EMG) which measures a signal sent down the arm to the tip of the fingers. This test is done to identify any nerve damage.
I had the sensation for 6 months mainly in the thumb. Regards.

10/07/2014 11:52
wach 

Administrator

10/07/2014 11:52
wach 

Administrator

Re: Post surgery issue

After a standard (45 degree MCP) surgery it took me 2-3 months before I could actively make a fist again and 6 months until the swelling was completely gone. As Henry wrote, it's too early to judge the outcome of your surgery and too early to be concerned!

Wishing you a good and fast recovery

Wolfgang

10/07/2014 13:26
emelem 
10/07/2014 13:26
emelem 
Re: Post surgery issue

Thanks Everyone. I guess I wasn't fully prepared for the after effects of surgery. I had hoped for a speedier recovery. Or, at the very least, that swelling would subside by now. But my hand is still really swollen, stiff, sore and flaring. And this new issue with nerve compression has put my PT on hold.

I've played fingerstyle guitar as a hobby for the past 35 years, and miss it terribly.

10/14/2014 15:53
FLNative 
10/14/2014 15:53
FLNative 
Re: Post surgery issue

emelem:
Thanks Everyone. I guess I wasn't fully prepared for the after effects of surgery. I had hoped for a speedier recovery. Or, at the very least, that swelling would subside by now. But my hand is still really swollen, stiff, sore and flaring. And this new issue with nerve compression has put my PT on hold.

I've played fingerstyle guitar as a hobby for the past 35 years, and miss it terribly.


You may want to research Reflex Sympathetic Dystrophy (RSD). Best wishes....

10/23/2014 13:07
emelem 
10/23/2014 13:07
emelem 
Re: Post surgery issue

My doctor is ruling out RSD (for the moment). He says that the flaring and swelling I'm experiencing is fairly typical for 8 weeks out. Its really debilitating. As for the numbing and tingling, I'm having some nerve tests done, because I may have developed carpel tunnel syndrome. Perhaps more surgery.

The pinkie of my right hand (the one that didn't have surgery), has a PIP contracture of about 70%. Based on my experience so far, it now looks perfect to me.

11/14/2014 16:36
emelem 
11/14/2014 16:36
emelem 
Re: Post surgery issue

Just completed neurological testing and have been diagnosed with Carpal Tunnel Syndrome. Not a single CTS symptom before my DD surgery.

11/15/2014 07:45
spanishbuddha 

Administrator

11/15/2014 07:45
spanishbuddha 

Administrator

Re: Post surgery issue

Sorry to hear about the tough recovery. IANAD but until swelling from the surgery is down, I would keep an open mind about the diagnosis of new problems. A colleague who had a pinkie amputation had swelling (for no particular reason) for 6 months or so after the operation. Hang in there, do the exercises but not overdo them, if or when you can without aggravating things.

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