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Questions...
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01/25/19 16:41
Luciferette 
01/25/19 16:41
Luciferette 
Questions...

Hi all,

Had my second pinky PIP joint fasciectomy (LH this time) last Thursday (17th Jan) -- a dermo was planned but plans changed! I'm managing ok, non-dominant hand and this time they left my index finger and thumb out, which makes life much easier for someone living alone.

Just a couple of questions...The surgeon did a joint release this time, as the 90 degree contracture was totally rigid (quite alarming how quickly it progressed). He did explain it to me after the surgery, but I'd had a GA and morphine and didn't really take it in :) What does a joint release entail, and are there any particular tips for recovery?

I was supposed to have my plaster cast off today, but I slipped on the ice yesterday and couldn't get a lift to the hospital (couldn't face the walk from the bus station)! The next appointment with the hand therapist they had is next Wednesday (30th Jan). So next question: does it matter if the plaster stays on another four days? My hand feels ok, I'm using my available fingers as much as possible and wiggling the others plenty. I'm guessing it might just take a bit longer to get the finger moving again? I spoke to the orthopaedic ward because it's been impossible to get through to the hand therapist and they didn't seem to think it would be a problem.

Any answers/advice much appreciated!

Thanks,

Lucy.

01/25/19 18:47
spanishbuddha 

Administrator

01/25/19 18:47
spanishbuddha 

Administrator

Re: Questions...

Luciferette:
Hi all,

Had my second pinky PIP joint fasciectomy (LH this time) last Thursday (17th Jan) -- a dermo was planned but plans changed! I'm managing ok, non-dominant hand and this time they left my index finger and thumb out, which makes life much easier for someone living alone.

Just a couple of questions...The surgeon did a joint release this time, as the 90 degree contracture was totally rigid (quite alarming how quickly it progressed). He did explain it to me after the surgery, but I'd had a GA and morphine and didn't really take it in :) What does a joint release entail, and are there any particular tips for recovery?

I was supposed to have my plaster cast off today, but I slipped on the ice yesterday and couldn't get a lift to the hospital (couldn't face the walk from the bus station)! The next appointment with the hand therapist they had is next Wednesday (30th Jan). So next question: does it matter if the plaster stays on another four days? My hand feels ok, I'm using my available fingers as much as possible and wiggling the others plenty. I'm guessing it might just take a bit longer to get the finger moving again? I spoke to the orthopaedic ward because it's been impossible to get through to the hand therapist and they didn't seem to think it would be a problem.

Any answers/advice much appreciated!

Thanks,

Lucy.
Simplistically, I’m sure you know fingers are moved by tendons on both sides, held in place by pulleys. If joint freedom is in any impaired, capsule, ligaments, cartilage, scarring, etc, the restriction will need to be removed or released so that the tendons operate on a free joint. The specific details will depend on what the surgeon found. There may be trauma from surgery so joint mobilisation and tendon glide exercises should start ASAP. Page 12 onwards of this publication may be interesting reading for you https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4124823/

01/25/19 19:07
Luciferette 
01/25/19 19:07
Luciferette 
Re: Questions...

Thanks so much, SB, as ever. That's an interesting article; if I've understood it, I think the physio side of things will be even more important this time round to get the best results from surgery. My RH contracture is at about 30 degrees now, a great improvement on its pre-op condition, although my knuckle pads etc are still very sore. There's a new nodule starting in RH 3rd finger, just below the PIP joint again...the LH pinky went from nodule to full contracture in less than a year, so I'll be keeping a close eye on this new development.

I'm hoping I'm not going to harm things with the cast being on a few extra days!! :(

Thanks again, this forum is a godsend.

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