What to expect with Surgery

Will my hand be NORMAL after surgery?

Surgery is not a normal event for the human body to go through. Wherever surgery is performed scar tissue forms. Scar is not normal tissue. We try to minimize scar formation by using sound surgical techniques and appropriate post-surgery therapy. The goal of surgery is to give your hand as normal function as possible.

When will I be all better?

The length of time to recover from surgery will depend on the surgery performed. Most surgeries have a 2-4 month healing period. Additional changes keep taking place for up to 2 years.

Is surgery guaranteed to solve the problem?

NO! No surgery in the world has 100% good results. The very best procedures are about 95%. Most surgeries are between 70-90%. Some surgeries are even as low as 50/50. Why do we operate if the results can not be predicted any better than that? Surgery is done to improve the overall situation. Sometimes partially solving the problem makes life much more livable. Deciding when surgery should be done and what procedure should be chosen is very difficult and requires a lot of judgment.

What can I do to improve my results?

Everything! You have more opportunity to make a good or a bad result for yourself than even your surgeon. What happens after surgery really counts. You will be doing therapy on a daily basis. Some of you will work with hand therapists. Some of you will work on your own. Study the Hand Therapy Basics part of this packet to learn how to do proper therapy.

Can serious problems arise during or after surgery?

Yes. Although rare, a problem (also called complication) can occur after surgery. Some complications are more serious than others. All of them have to be treated. The patient who admits a complication is happening and does what is necessary to get over it will usually be OK. The patient who denies that a complication is happening or dwells on asking "why me?’ will usually develop a difficult problem. Some complications cannot be prevented. Fortunately, this type of complication is very rare. Luckily most complications can be prevented by carefully following instructions. Let’s go over the most common ones ahead of time.

Swelling: Occurs 100% of the time. Combat swelling by keeping the hand as high as possible the week after surgery. Pump swelling out of the hand by using the muscles and doing exercises like the "six-pack" exercises shown in the diagram included with Hand Therapy Basics. Do not try to move any part that has a splint on it.

Stiffness: Occurs 100% of the time. This will be the hardest part about having hand surgery. You will not believe your hand/wrist/elbow could ever be this stiff. The earlier you can get back motion the better. Once stiffness sets in, it is very difficult to get rid of.

Numbness: Every incision cuts through small nerves in the skin. This may leave a patch of numb skin near the incision. The size of this patch usually gets smaller with time.

Hypersensitivity: Hypersensitivity after surgery can become a problem if it gets out of control. Fortunately this is very rare. After surgery your nerves can become very sensitive. Massage and early motion are best at preventing this problem with direction from your therapist or doctor.

Infection: this is one of the most feared complications. You can diminish the chance for infection by following your instructions on dressing and wound care. Do not let your dressing get wet. If you think you are developing an infection, call the office immediately. Fortunately, infections are very rare but they still can happen.

Failure to heal: No matter how well they’re put together, not all injured or repaired structures will heal in a timely matter.

SMOKING!!!!!!!!!!!!!!!!!!! Smoking increases the risk of all these complications. You must really stop smoking before your surgery. So, I congratulate you on the decision you have just made to quit smoking. If you can’t, you should seriously consider not having your surgery. It is that dangerous!

Other complications: There are many more possibilities that are fortunately uncommon. If these problems arise, the best thing to do is meet them head on. A motivated patient can overcome most problems with enough time and effort.