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Cannot make a fist following surgery
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08/04/2005 23:57
Stephen Revill

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08/04/2005 23:57
Stephen Revill

not registered

Cannot make a fist following surgery

Two years after corrective surgery on my left hand, I still cannot make a fist as three fingers are now rock solid. Before the operation, I could easily make a fist with this hand.
I now need surgery on my right hand but am reluctant to have it done as at the moment, I at least have one hand that will open and one that will close.
Does anyone know what causes this and can further surgery improve things ?

08/04/2005 23:30
Graeme

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08/04/2005 23:30
Graeme

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Hand surgery

Is your problem to do with the aftermath of Dupytren's surgery, or is it something else?
Have you sort out second or third opinions from suitably qualified medical practioners?

08/04/2005 23:40
Stephen Revill

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08/04/2005 23:40
Stephen Revill

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PT

Yes, this is following Dupytren's surgery. Doctors can't seem to give a reason why though.

08/04/2005 23:54
Sean 
08/04/2005 23:54
Sean 
PT

What type of physical therapy did you follow? I know my hand would have probably been that way, but the very diligent physical therapy made the difference.
What type of surgery did you have?

08/05/2005 23:17
Stephen

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08/05/2005 23:17
Stephen

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Follow up

Therapy? That I think was the problem. I was given no advice after the operation and when I went for a follow up after six weeks, I was asked if I had been wearing my splint. Problem was, no one had given me a splint or even mentioned one.
Six weeks after the operation, my hand was as bent as before the operation but by placing my hand on a flat surface and pushing down on it (and now with the help of a splint), I managed to sraighten the hand.
I'm not very pleased with the post operative care I received. I never even saw the surgeon again after the operation and every time I went for a follow up, it was a different doctor.

08/05/2005 23:46
No Name

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08/05/2005 23:46
No Name

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Follow up

Stephan,

Your comments about no followup care are really hard to believe and the idea that a surgeon or hospital would let you go without the standard post-opt discussion is unbelievable. Please provide details: the doctor, the hospital, etc. Are you sure you did not get the advice and not follow it?

08/05/2005 23:19
Stephen

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08/05/2005 23:19
Stephen

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Re: Cannot close hand

Believe me, what I have told you is absolutely accurate. All the advice I got was from a nurse on the ward who told me to start moving my fingers after 3 days.
Once I was given the information on what to do (six weeks after the operation), I followed their instructions to the letter, even though it was extremely painful to flatten my hand.

08/06/2005 23:13
Wolfgang Wach

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08/06/2005 23:13
Wolfgang Wach

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Re: Cannot close hand

I had surgery on my left hand and had similar results. Due to surgery I could straighten my hand again but I could not make a fist anymore. After digging into literature I found a paper from a German surgeon who describes problems of bending fingers and making a fist after Dupuytren surgery. This affects about 20 percent of the patients and is attributed to a stenosis of the sublavian vein, a disorder of the arm's vein. This results in swollen and eventually stiff fingers. I my case, after two years, I now can make a fist again but it still hurts a little.

If you are concerned about having surgery on your other hand, too, then you might consider alternative therapies like radiation therapy (very effective in early stages of Dupuytren) or you might consider to participate in the phase II of the collagenase therapy. Needle aponeurotomy can provide relief with typically less side effects than classical surgery: But it will not cure the disease and hass to be repeated. E. g. the non-profit Dupuytren Society provides information on various therapies at www.dupuytren-online.info (I am a member of it).

Good luck!

Wolfgang

08/09/2005 23:40
stephen

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08/09/2005 23:40
stephen

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NA vs. surgery vs. collagenase injection

Thanks for that information Wolfgang
Stephen

08/09/2005 23:39
Randy H.

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08/09/2005 23:39
Randy H.

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NA vs. surgery vs. collagenase injection

Wolfgane,

I completely share your enthusiasm for our hoist's Collagenase injections. We need all the noninvasive treatments we can get. However, I might be inferred from your last post that Collagenase treatments don't suffer from the same higher rate of recurrence when compared to Open Surgery. You mentioned recurrence only in regard to NA. However, since both treatment do *exactly* the same thing, wouldn't it follow that they would yield similar long term results?

This is one of my arguments to counter current NA resistance. There is a *lot* of interest in Collagenase among Surgeons. At the same time, however, they point the finger at NA saying recurrence is too high. They should be *equivalent*. You can't complain about NA recurrence while being interested in the promise of Collagenase. Plus, the actual recurrence rates compared to OS are still unknown.

I have probably suffered the same fate as yourself in regard to major residual swelling of the joints on my surgically treated hand. I'm 2 years plus. Still painful, *especially* in cold weather. The idea that this is permanent is disturbing. I think 20% is way too high. You are the first I've heard of with a similar condition.

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