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What to expect after Duputren~sq~s surgery
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Jim Murphy

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Jim Murphy

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What to expect after Duputren~sq~s surgery

I had surgery a month ago and would like to find others in the Atlanta area to compare results. How long does it take to heal sucessfully, etc.? What have you learned from your experience? I live in Northwest Atlanta, retired. Would love to hear from persons having similar surgery. Thanks

Gary Evans

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Gary Evans

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Recent surgery

Jim,
What type of surgery? How old are you? How much contraction did you have? Are you doing therapy yourself or with a therapist (or both?)? What stage are you at now? Stiffness and swelling in knuckles? You should be getting better each week. The more you flex the area the better. When my surgeon told me that I could not overdo the flexing, was when I really started improving. The use of Coban (a 3M product) helped as much or more than anything. I had 90 degrees contraction before surgery (Jan.2002) and now hand is at 0 degrees and total flexibility. I put lotion (Aveeno) on hand several times a day to keep scar tissue continually moist. Also massaging scar tissue is important. Wearing nightime splint is essential. You will know when it is no longer necessary. Keep flexing hand in both directions to continually break loose scar tissue. I never had any pain so all of this was quite manageable.

Good luck, questions are good.
Gary

Jim Murphy

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Jim Murphy

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Recent surgery in Atlanta

Thanks Gary Evans for your excellent response. I am 78. Contracture was little finger, left hand, 75 degrees and I think was getting worse. I did not do much up front research but went to the Georgia Hand Clinic in Atlanta (5 surgeons)and simply trusted one of them to take good care of me. He is a plastic surgeon with hand training. He told me they had about 98% success with DC surgery and they do about 100 a year. If I had talked with many patients before surgery I might not have had the surgery, but I really wanted it done and took the chance. The clinic has a therapy center and I am now with them twice a week. They seem good, and very caring. Seems to me that most of their patients are job related injuries and rehab however. Your advice is on the mark and much appreciated. I am hoping for a fairly good outcome but don't know yet. Recovery takes much longer and is more complicated than I knew about.
I would like to ask you a question or two later if I may. Jim

Gary Evans

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Gary Evans

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Recent surgery

Jim,
Questions are good. You will notice great improvement after swelling is gone and scar tissue starts healing well. Second thru forth month should show rapid improvement. At this time for me(10 months post op.), you can't tell that I have DC or had surgery. Hand is totally functional. I was golfing in 2 1/2 months after surgery.

Did you have a choice of type of surgery? Or did they just do it? I think that is where knowledge by the patient is helpful. Often, at your age, they would consider a less invasive fasciotomy, rather than a fasciectomy (I assume that is what you had).
Keep in touch.
Gary

Jim Murphy

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Jim Murphy

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Recent surgery in Atlanta

Gary Evans, mine was fasciectomy. No choice was discussed.
Do you think outcome is mainly the skill and DC experience of the surgeon, or many factors including age of patient? I am following your and my therapists' advice and hoping for an acceptable long term outcome. Long way to go though. Try to close fist and feel like I am holding a walnut in my palm. Don't see my surgeon again for a while unless therapists see need. That seems to be the system which I guess is OK except there are so many questions and concerns. Don't know if experienced people can accurately predict outcome or if it is mostly "time will tell". Read of lots of quick reoccurrance which is not encouraging. What is Coban? Many thanks for your support. Jim Murphy

Gary Evans

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Gary Evans

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Recent surgery

Jim,
Your progress is normal. Each month that goes by, will be better. Coban is an elastic bandage (1 1/2" wide) (you are probably already using it) that comes in rolls. I would cut off about 12" and make a rubber band like device(it sticks to itself). I would then make a fist and put this tight band around fist (to make it a tighter fist) for 10-15 minutes several times a day. Then flex fist in different directions after removing. I would put the COBAN on in different directions. This band is reusable for about a week, then make a new one.
All (most) studies show that a fasciectomy has less recurrence than any other procedure. Some procedures, such as segmental Aponeurectomy have similar recurrence results. DC is unpredictable in itself, so variable factors of patient and surgeon disparity do create havoc with predictability. I know six people who have had fasciectomies with absolutely no problems from the surgery or recurrence. Recurrence is most likely for those who developed DC and required surgery at a young age. As I said previously, my finger was at 90 degrees contraction and is now at 0 degrees and you couldn't tell that I have DC. It is 100% functional. There are hundreds of these surgeries done weekly around the U.S. and you just don't hear of that many problems, except on complaint forums like this(and that number is small). My surgeon said it was very rare that he had to do a surgery for a second time on a person. Moermans(a world authority on DC) said that "the first operation, is for most people the last one"(1997).

I saw my surgeon at 1 week, 2 1/2 weeks (to remove stitches) and one month. He then told me he didn't expect to see me again. I only went to therapy twice, to get nighttime splint and to get exercise list. All of the rest of the therapy, I did on my own. I thought the progress was interesting to follow. When the swelling in the joints went down, the flexibility really improves. You will get into a habit of flexing your hands and that really helps. I wore the nighttime splint for about 3 months and then once in a while if I felt necessary. I would also put splint on during the day for 10-15 minutes sometimes.

Good luck, keep asking questions. The questions are good for everyone.
Gary

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