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operated on too soon?
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02/27/07 19:21
marks 
02/27/07 19:21
marks 
operated on too soon?

Hello,

I'm 42 years old and have had a nodule in my right palm-dupuytren's, but my finger or fingers were never contracted at all. I decided to go ahead with surgery, but am afraid I may have done it too early. I started reading up on this disease "after" my surgery. I'm an American living in Germany, and have searched all websites here and there, hand clinics, etc. and know one operates on your hand unless your finger is bent 20-30 degrees. Now, I'm worried my hand won't be normal anymore. It's been almost two months since my palm was cut open, my ring finger joint is tight, my tendons in the palm are tight throughout the day, and worse at night. My palm also turns blue and purple around my scar and most of my palm when my arm hangs down. If I raise it up, it looks normal. I don't even know any hand doctors in the town I live in and recently visited that would of touched my hand, but a regular doctor in the hospital told me best to do it now. He's the only one.

My question is do any of you know people who have had this done too early, like myself, when just a nodule was present on one hand, and if there was any complications? I even read up on radiation therapy for people like me who didn't have bent fingers yet, bu now, of course, I don't qualify for that anymore. I never even tried cololagen shots yet. Why would this doctor do this?

Thank you

02/27/07 19:35
wach 

Administrator

02/27/07 19:35
wach 

Administrator

Re: operated on too soon?

Hi Marks, I just saw your note: occasionally Doctors do operate already small nodules but that's not the common procedure. The justifaction for early surgery might be to exclude a malign tumor or to avoid damage by further growth. Both I would personally question. But in your case it's too late anyway and the goal to recover quickly. If you are not satisfied with your post-Op treatment why not having a 2nd opinion? It will always require a doctor to look at your hand and diagnose your current status before any therapy can be advised.

From what you are writing it sounds like that your hand might still be swollen, too. I myself had surgery and it took months before the swelling disappeared. I understand that this is not normal but it does happen.

take care
Wolfgang

02/27/07 19:45
marks 
02/27/07 19:45
marks 
Re: operated on too soon?

Thanks for your reply Wach,

yes, it's still swollen, but not as bad as the first month. They say the swollenness comes from water, etc. and it can't be drained because your hand is like a sponge and it takes time for it to drain out. I'm just burned out because my hand was normal (besides the nodule) before the op, and I can't see why 99% of hand specialists all over the world won't touch you unles your finger or fingers are bent 20-30 degrees, but this doctor goes ahead and cuts and doesn't even recommend any other treatments first.

Well, your right-get a second opinion on post op recovery. I went to two hand specialists (should of went before) and they both said they wouldn't of touched my hand, but that the swelling and tightness is normal and I need 3-6 months. Just hope my hand is normal after all this. I don't think German doctors and hospitals can be sued.

Thanks for your insight,

Mark

02/28/07 13:52
wach 

Administrator

02/28/07 13:52
wach 

Administrator

Re: operated on too soon?

Hi Mark, below comment from a recent overview publication reminded me of your surgery:

"Surgery is the most widely used treatment for advanced Dupuytren disease. Flexion contracture of the metacarpophalangeal joint of > 30 degree and flexion contracture of the proximal interphalangeal joint of > 15 degree interfere with function and, in the presence of a well-developed cord, are indications for surgical treatment."

Ghazi M. Rayan "Dupuytren Disease: Anatomy, Pathology, Presentation, and Treatment" J Bone Joint Surg 89A (2007) p 190 - 198.

Note that surgery is "for advanced Dupuytren disease" and indication is flexion contracture together with a well-developed cord. You had neither.

Wolfgang

02/28/07 21:14
marks 
02/28/07 21:14
marks 
Re: operated on too soon?

Thanks again Wach,

I'll keep this info handy in case I don't heal properly in a couple more months. I'm already wishing this would of happened in the U.S. where malpractice suits pay quite more than what they do in Germany. But, I'll keep going to therapy and working my hand out, even though I got butchered for nothing. In the end, no matter what happens I'm still stuck with my hand, normal or not.

Many thanks,

Marks

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occasionally   surgery   specialists   treatment   metacarpophalangeal   complications   contracture   operated   well-developed   justifaction   indications   personally   Dupuytren   Presentation   malpractice   palm-dupuytren   swollenness   publication   disappeared   interphalangeal