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Has my surgery failed ?
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05/31/19 09:16
Valwil18 
05/31/19 09:16
Valwil18 
Has my surgery failed ?

Hello I’m new here. I’m in the UK and had a fasciectomy to my right hand little finger on the 8th April. I’ve had Dupuytrens for at least 6 years. I tended to ignore it as it wasn’t painful but it started to affect my job as a nurse practitioner as I couldn’t examine patients normally.
My gp referred me straight away and at the initial appointment I saw a physio therapy practitioner. She measured my finger and said it was too advanced for other treatments and needed surgery. She went through the consent form with me and discussed the usual side effects of anaesthetics, post op complications etc. Anyway I had the surgery approx 6 weeks later under a general anaesthetic as an out patient. I briefly saw the anaesthetist and surgeon prior to the operation. The op seemed to go well, I wasn’t in too much pain and I was followed up a week later by a physiotherapist. She took my dressing off and measured me up for a night splint and dressed my wound. I had dissolvable stitches in.
Here’s where the problem started. I started to get intense nerve pain like electric shocks radiating down the outside of my little finger and hand. It would also constantly throb like ‘toothache’ in my hand. My finger also started to bend inwards despite me doing the physio exercises and wearing the splint. I then got an infection in the wound. I continued to see the physio weekly and 4 weeks later saw the original physio practitioner who had consented me for the op. I’d been leaving the dressings off by this point and my wound was almost healed. The pain however was still intense. I could hardly bear her to touch my hand and finger despite her trying to force the finger back.
The pain in my hand has gradually got worse. I can’t hold a kettle, can’t wash my face, can’t place my hand flat to a steering wheel. I’m back at work and they’ve had to get me a specially adapted mouse for the pc as I couldn’t place my hand on the other. I’ve been awake since 4am with intense nerve pain. I’m taking Gabapentin 300mg TDS and Nortriptyline at night with little effect. It’s had an effect on my relationship as I’m constantly miserable. My finger is now so bent that it’s almost touching my palm and now my ring finger is bent also and that wasn’t affected before. The redness, swelling and deformity looks awful. My little finger and ulna aspect of my hand are also constantly numb.
I saw the physio again on Wednesday and she was just wanting me to force the fingers back etc but I asked to be referred back to the surgeon. I wasn’t offered a follow up review with him. I sometimes feel when the pain is so intense, that amputation would be the best option as I can’t see how further surgery can improve this.
Has anyone ever heard of this happen?
Thanks for reading, I feel better already from my little rant,
Val x

05/31/19 13:05
spanishbuddha 

Administrator

05/31/19 13:05
spanishbuddha 

Administrator

Re: Has my surgery failed ?

Hi val, so sorry to hear your story so far.

Normally I would consider it too early to judge if the outcome has been successful, but your description does not sound hopeful. There can be quite a few side effects from surgery, infection, nerve damage, scarring, CRPS, and the contracture recurring almost straight away either from scarring, the joint or cords remaining. It sounds like you have the lot and each needs a different treatment approach.

I am a bit confused about who did the surgery, was it a BSSH member with lots of DD experience? I would be inclined to ask for their opinion and support. Otherwise see if you can get help from elsewhere. An established team used to treating DD and recovery.

The healing should settle down eventually, but may take some time, it can be months, although you should get help with possible CRPS, swelling and inflammation, prevention of external severe scarring or keloid. Hopefully once past this acute stage the finger will be better than before, otherwise a new consultation to establish what can be salvaged as your next step. Let us know how it goes from now on.

Best wishes

05/31/19 15:20
wach 

Administrator

05/31/19 15:20
wach 

Administrator

Re: Has my surgery failed ?

I am not familiar with the English Health System, while SpanishBuddha is, but just in case you need a second opinion, here are a few specialists for Dupuytren Disease (of course there are many more of them in the UK, this is to name just a few):

in Southern England e.g.
Southampton: Prof. David Warwick https://www.handsurgery.co.uk/
more in the Center of England e.g.
Leicester: Prof. Joseph Dias https://www2.le.ac.uk/colleges/medbiopsy...sor-joseph-dias
Derby: Dr, Chris Bainbridge http://www.hand-surgery.co.uk/
There are also several in the Oxford area.

Wolfgang

06/14/19 12:05
Valwil18 
06/14/19 12:05
Valwil18 
Re: Has my surgery failed ?

Thank you both so much for your replies. I’ve been referred back to the same surgeon and I’ll see him on the 27th of this month. Not sure I trust him anywhere near my hand if I’m honest as it’s a right mess. My ring finger which was fine before the op is now swollen and bent even more than my last post.
Dr Chris Bainbridge is nearer to me so I’ll make enquires about a possible consultation with him I think.

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complications   Bainbridge   Southampton   anaesthetist   Nortriptyline   hand-surgery   surgery   physiotherapist   constantly   relationship   appointment   SpanishBuddha   specialists   anaesthetics   inflammation   consultation   ‘toothache’   dissolvable   sor-joseph-dias   practitioner