trigger finger / CT - Is my surgery progress pretty normal?

I have had bilateral CT, rt hand worse, for many many years, but resisted surgery because of the time off work. Last July after some particularly rough yard work, I developed trigger finger in the rt hand, middle and ring fingers. The ring finger was worse than the middle, but both were progressing and not improving. I asked for OT, but it only improved the pain and not the function, so I had surgery on the rt hand for open CT, and middle and ring trigger finger on December 22nd. I didn't want shots as I wanted this permanently fixed, and didn't want tendon thinning prior to surgery. In responding to posts, I think it's important to know whether this is done open or arthroscopic as while I understand that the post op for open is more involved, the doc said it was the gold standard in terms of outcomes. My surgeon has 17 years experience in these procedures, and a good reputation in the area.

Anyway, all I got as as far as post op instructions was to do ROM on the hand from day 1, and try to close and open it as far as I could tolerate it without causing it so much pain I had to take more meds. Actually, I only took two of the prescription pills as I have an aversion to pain meds--they upset my stomach and cause constipation, not something I needed then. So...I got online and looked at other ortho post op sites and downloaded exercises for open CT and trigger finger surgeries and did those. My stitches did spread a bit, but I had them out on day 16, and the doc said it was healed underneath, so don't worry about surface spreading. I left the steri strips on two more days, then began the vitamin E rubs and continued exercises.

I asked for OT, and saw them on day 17, and got electric stim for the pain, and tendon glide exercises for CT & trigger finger, plus two sheets of finger mobility exercises, and continue to ice it twice daily. Side note; the icing and elevation in the first two weeks really didn't do much for the swelling. I think the gentle exercises did more as far as reducing the swelling, and it made the hand more flexible as well. I could pretty fully extend, but not completely close the hand on the day stitches came out. I also used a good hand cream on the surgery hand, but didn't get closer than an inch from incisions. That made the stretching more comfortable.

The OT did a functional assessment, and my fingers are still swelled about double, and I have a blue tint to my palm and at the base of my fingers. Pain is still present, and I am very stiff and the middle and ring fingers are hot in the AM. Flexibility doesn't improve until early afternoon after lots of exercising in the AM. I still haven't washed the incision area yet as I'm not sure it is fully healed.

The OT thought I was doing very well, but does this sound normal to those of you who have gone through similar surgery? The doc didn't give me any indication that post op would be so involved, so I was as unprepared as most people going through this. I'm trying to stay informed though.












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Welcome to the forum.

Everything looks about like what I experienced with 3 trigger fingers, although I did not have CT. The bruising is about what I experienced. The skin will peel around the incision, and there will be a small scar, but it's lots better than having the pain and stiffness of trigger fingers.

The one thing I would ask the doctor about is the swelling. Double normal is a lot! I didn't have that much, maybe 1 1/2, but no more.

Don't push the exercises too hard at first, but keep doing them. It shouldn't hurt too bad, but it will hurt some for a long time. I remember at least a couple of months of pretty annoying pain after the first week of really bad pain. It took several months of massaging several times a day to get full range of motion, and that's when the pain disappears. I found I needed to massage and stretch the fingers pretty hard after the first couple of months to get back to my original ROM.

Thanks for the info about scar peeling. I think those tight scabs were what were hurting the most. I tried rubbing fairly hard (doc's instructions) with the contents of vitamin E capsules mixed with olive oil, but finally switched to vaseline as the heavier texture seemed to make the scabs peel off quicker. When they were mostly gone, more of the surgery pain went too. This happened around day 18-20 post surgery. As they peeled back, I trimmed (only dead flaky parts) with cuticle scissors. While this was happening, I avoided anything more than just brief hand washing and patting dry. I'm giving all the details as no one told me any of this, and it would have helped to know in advance what to expect. My hand isn't nearly as stiff and inflexible as I thought it would be now that the scabs and dead skin have peeled back, but I still can't make a complete fist. On the other hand, it will go further than it would with the scabs still on, so that's progress.

Continuing to do the OT exercises and they help A LOT. If there was a way to post those, I would do it but can't find a way to attach anything. That might help others whose insurance won't cover OT services.

Oh, another thing I did was mix just a tiny amount of a crushed bromelain tablet with hand cream and rub it on the surgery hand but stay away from incisions by about an inch. The swelling and tightness was really holding me back from exercising it, and the bromelain brought the swelling down and also helped with the tightness. Apparently bromelain can be absorbed through the skin, and internet searches suggest that it speeds healing and reduces adhesions after surgery. It is advised not to use it prior to surgery, but post surgery, it is ok. The OT will use ultrasound on my hand next week to also help break up the adhesions, but the bromelain this week helped until I get in for that. I wouldn't overdo this, but it seems to help at those times when the adhesions are really pulling a lot and you don't know if it is ever going to bend normally again. I could tell a difference within an hour or so. I haven't seen this tip anywhere else on this board; I found it while searching sites about healing after surgery. There apparently is a topical form, but since I had the tabs at home, I tried it this way and it seemed to work.

Thanks to those who took the time to reply to my first post. Knowing that others have experienced the same thing does reassure me that everything is progressing normally.

I had trigger finger surgery 1 month ago today. I went before it got really bad, as my sister waited too long and had a little more difficulty than I wanted. Very good surgeon. My procedure took a little longer than normal (35 minutes) because I had been stuck with a pencil by a kid in HS 55 years ago and the graphite was still in the upper surface/knuckle of the same finger that was now triggering. I asked the surgeon, while it was numbed, to remove this foreign object and he did. I recovered quickly. 4 stitches. Very little to any pain at all. One thing that surprised me was that the numbing shot (yes I said one shot) took all of a count of 1-1000 and it was over - unlike the horror stories I had heard about this part. I had watched YouTube videos of the injection and some docs almost never got through injecting here there and everywhere. Not mine. The finger still clicks now and then but does not trigger. I massage the incision site daily pretty aggressively and that seems to help, plus I use a warm water bath for the hand to help get it going each day. I still cannot completely straighten the finger (middle)- about 95% now. The doc and I agree that this is possibly due to the additional surgery to remove the graphite right at the joint of the same finger. He told me it takes 3-4 months for swelling to go down. All in all I am pleased, looking forward to getting complete straightening though. Glad I had it done and glad it didn't mirror those horror cases I had heard of.

Post Edited (miragesgdh2013) : 8/9/2015 1:53:06 PM (GMT-6)