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  1. #51
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    I can wiggle a little as well - but if I look carefully I think much of it is extension first and then a natural return to rest. If I carefully block and try to isolate just the IP joint, I get a little - maybe 3-4 mm of flexion. Not much, but it proves the FPL is still connected at least and hasn't ruptured.

    My scars have responded really well to the paraffin baths - the scabs have all sloughed off and the scar massage is going well. My carpal tunnel area at my wrist feels like a rock though - massage loosens and the cycle continues - just need to stay on it. As in the past, I'm a big scar maker so this is a big concern.

    I've started using the silicone sheeting at night to help reduce scar formation. Does your OT have you doing that?

    I have a small, but very solid lump up my forearm where they harvested the palmaris longus; about the size of a decent peanut M&M and just as hard. Massaging that really well also and it has already started to respond, but sore.

    The thumb is very flexed right now and I have little extension of it, but they haven't told me to start stretching it upwards yet. I really hope that comes around, feels like if I had more room to move it back and forth I'd get more movement of the FPL repair areas as well.

    I'm out of the splint at home and the office a fair amount as long as I'm careful not to grab or lift anything with that hand.

    How are you coming along?

  2. #52
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    My wrist is like a rock, too. I bought a massager called a carpalrx to see if that will help any. It hasn't arrived yet, but I will keep you updated as to how it works.

    My scar in my palm was pretty bad - I have been using the walgreens brand of scar cream (similar to Mederma) for the past two days and I am impressed with how much the scar has broken down, so quickly. When I bring my thumb to the bottom of my pinky, that scar now has wrinkles in it and I am gaining my range of motion back with that stretch... before that scar was stiff and wouldn't budge. I recommend trying that scar cream, if you haven't already. I just started the silicone sheeting tonight... hopefully it helps!

    The tip of my thumb seems to be right where yours is at... if I hold it down and stretch it for a while and then let go, I can hold it very slightly bent for a while, so I know the tendon is still there... hopefully the mobility comes back more and more each day as the swelling goes down and it doesn't reach a stand-still. I am trying to keep it moving as much as possible.

    Did they tie your tendon tight making it hard to do a thumbs up, also? I can't even come close to doing a thumbs up right now, but they told me that should come back in time...

    Best of luck!

  3. #53
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    Yes, my thumb is very flexed when they decided how much tension to put the tendon under during surgery. Very awkward feeling, more so than with the silicone rod first stage.

    But in the last 2 days I've noticed some improvement in that. I've been starting to rest my thumb tip on the side of my index finger - could barely do that and now I am starting to slide it along my index finger. That little bit of additional stretch has made trying to form circles between thumb tip and finger tips far easier.

    Let me know how the carpalrx works out. The paraffin baths at home 3x a day are awesome.

  4. #54
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    Ruptured tendons do "just happen" in cases where the tendon has gone unused

    Quote Originally Posted by online2 View Post
    Codecruncher - I initially had my right thumb flexor tendon sewed back together after an accident with a knife when I was 18. It was kept in a hard cast for 6 weeks with no movement (big mistake) and when the cast was taken off, my thumb had scarred stiff to where I could not bend it, even after PT... I lived with this for 10 years...

    I decided to have tenolysis surgery to release the scar tissue from the flexor tendon. The surgery was done on 3/19/14 and seemed as if it was a success since I was able to see my thumb fully bend for the first time in 10 years while it was being operated on, before it was sewed back up. 1 day after the surgery I had the bandage wrap taken off and started PT and movement of the thumb as much as I could.... It had become swollen and was hard to bend, but I was told to keep working at it 10-15 times per day... It remained swollen... Long story short, the tendon ruptured 12 days after.... I was doing the exercise where you hold the bottom of your thumb and try to bend the tip... I did it too hard, heard a pop and that was it... I could no longer bend the thumb. I was devastated to be back to square 1.

    2 days after the tendon ruptured I went in and had tendon graft surgery...they used my palmaris longus as the new tendon.

    This was on 4/2 as well!

    It looks exactly like your thumb, but they did it in one phase.

    It has been 9 days since the surgery and I have been doing PT - The doctor said the tendon is stitched and woven together, so it is strong enough and shouldn't rupture... I am still not able to bend the thumb, other than wiggle the tip slightly and my palm and wrist are still sore and swollen. I had a lot more range of motion stretching the tip of my thumb to under the callus part below the pinky yesterday, but today I woke up very sore and swollen and a lot less flexible. I may have over did the PT and have been taking it real easy today trying to keep it splinted and elevated.

    I know these things take time and a ton of patience... I wish I would have been more patient after the 2nd surgery and avoided the rupture!

    My questions I hope you can answer are:

    How much movement are you getting out of your thumb? Is it swollen/painful still? Are you able to make a fist?

    Thanks and good luck with your recovery!
    Hi Online2,

    I had my middle finger frozen for a year and, like you, had tenolysis surgery to free up the stuck tendon and frozen PIP joint. The next day we got after it and I did PT every day for nearly 3 weeks. I was not warned to take it easy and had permission to go on a few MTB rides to work on strengthening the muscle and improve flexibility. So on the Monday 3 weeks to the day after my tenolysis and a half hour after my PT session I went home and started eating a doughnut and I felt like my finger had jammed and I couldn't move the tip of my finger anymore.

    Had an MRI 2 days later and it revealed that the tendon had ruptured. The following Monday I went back in for surgery to have a tendon from my leg grafted to the remaining "healthy" pieces of tendon left after the rupture.

    The reason I'm giving you the backstory on this is because when I went to see my doctor he said that a tendons tensile strength goes from 50% (the day of the surgery) and quickly drops to 5-10% at 3 weeks. After 3 to 3 1/2 weeks the strength of the tendon increases quickly to 70%+ at 6 weeks and 90%+ at 8 weeks. Now if I had had this information I would have gone a bit easier on the tendon leading up to that 3 week mark.

    However, I did have a lot of trauma to that tendon when I got the injury that froze my finger in the first place. (Dislocation at the PIP joint at 20MPH, opened up the skin, scar tissue from previous injuries was stuffed inside the joint when it was put back together, a 12 day infection that caused me to nearly lose my hand, harsh PT, and a year of non-use. All that probably caused the tendon to be in poor condition going in to the tenolysis.

    In a nutshell, don't blame yourself. Your tendon was weak from 10 years of non-use. Just keep in mind the timeline, get PT, do not take off the brace until 6 weeks and do not hyper extend your thumb until after 8 weeks. In fact don't do that at all, it causes arthritis. If you want it straight from a surgeon read this excerpt from an ebook (http://www.msdlatinamerica.com/ebook...9.html)...skip to the Complications section to see the pitfalls for yourself.

  5. #55
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    Hello All,

    Quick update. Had tendon graft from my leg to replace my middle finger's FDP tendon. I'm at 4 weeks and 2 days from my surgery. Been in a splint since the surgery, have less than two weeks left in the splint. Transitioning from passive only motion to place-and-holds. My passive flexibility is good due to the latest surgery removing more scar tissue from the previous tenolysis surgery and keeping my hand elevated 100% of the time day and night. I got a "Sponge Bob" cube to put my arm in at night. The place-and-holds feel good to move my limp fingers but no noticeable motion from my repaired finger at the PIP or the DIP. Going to take it slowly and try not to work it too much. Just passively stretching every hour and a half and then place-and-holds starting at the position with my hand closed just tighter than the position where I can hold for 5 seconds. I do place-and-holds for 2 seconds, then extend to straight, then place my fingers in position again and repeat until my injured finger is too tired to hold at that position any longer. I am using my other fingers to help the injured one by sandwiching it between them. My PT said that I should move them together and wait for a week before isolating the injured finger in a place-and-hold.

    So a few thoughts/questions for our little group:
    1. Does it seem like your PT and surgeon give you valuable information only after you have an incident, instead of before it happens, when you could have made a decision based on that information?
    2. Does intense PT make it harder to gain back flexibility due to the irritation it causes?
    3. Do you know of a website that caters to people with our types of injuries?
    4. Would you find it valuable to have a website that provides a community for people who could use emotional support, tips and tricks and just good advice?

    I'm considering creating a website where we as patients can pool our collective knowledge to make better decisions and get things right the first time.

    Your thoughts as always are appreciated.

    Alex

  6. #56
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    I'm 3 weeks post second stage tendon graft surgery today.

    I've noticed that my surgeon and PT people are generally more aggressive in their approach than any of yours. Maybe that's because my injury was thumb vs. fingers - or maybe he just moves faster. Examples:

    1. My hunter silicon stage 1 was only in for 8 weeks (and he was suggesting a range of 6-8 so I was on the long side). Sounds like all of you are closer to 12-16 weeks. Bonus: I got to keep the rod to see up close what was in me for all that time.

    2. At the urging of my surgeon since I scar quickly, PT had me doing place and holds on the thumb after stage 2 the very next day after surgery.

    3. My surgeon considered buttons "old school" and rarely uses them unless there is almost nothing left to connect the tendon to.

    4. They have me getting out of the splint for periods at my desk - like typing. But typing doesn't use my left thumb at all (I took formal classes way back in high school). I find I do a lot more PT a lot more often when in meetings or just at my desk if I'm not in the splint.

    I hope this approach works for me - not sure at this stage if it is better or not; just different.

    Like any health related issue, I find that I need to research outside of my doc and PT visits and come to them armed with lots of questions. I get the feeling that other patients don't take that much effort/investment in their own recovery.

    I don't think lots of PT makes it harder to gain back flexibility so far. I do take Ibuprofen afterwards to try to minimize swelling and irritation.

    I continue to see small improvements so I'm quite positive and just trying to remain patient with the 3-4 month recovery time.

  7. #57
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    Codecruncher that's great that you're seeing improvements, it will make your recovery period pass much quicker.

    I have super turbo charged scar tissue because of a disease called Dupuytren's Contracture, so we got after my therapy after my tenolysis. But then my tendon ruptured and I think my PT is being extra cautious about putting too much stress on my new tendon. Which leaves me with the very real possibility of needing another tenolysis. Which I can't bare to think about.

  8. #58
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    Hi all,

    I am 2 1/2 months post phase 2. I actually had my post-op appointment today. I am out of the splint completely now. And, my buttons were removed today. Currently, my two fingers are bending slightly when I attempt to make a fist. My little finger appears to be doing better than the ring. I am still no where near close to making a fist but can see some movement of those two fingers which previously didn't move at all. Unfortunately, my middle finger (which previously was not injured) will no longer move at the tip. The doc says that I may have developed some scar tissue from when she intertwined the tendons from my two fingers with that one. But that she is hopeful that it will come back in time.

    I have been told that I cannot ride a bike, or grip a steering wheel for at least two more months. I should only use the hand for light activities like eating.

  9. #59
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    CodeCruncher,

    How is your movement in your thumb? Are you seeing any improvements from 2 weeks ago?

    I just went in for a visit on Monday for a follow up with the doctor and he said that the tendon seems to not be gliding (getting scarred down again) and suggested I do not wear the splint AT ALL anymore and try to move it and exersize it as much as possible. They also made me a new splint to wear only at night to flex the thumb out, so I am able to do a proper "thumbs up"...

    I did my first round of ultra sound on that visit on Monday as well and started to actually feel the tendon glide (it was almost making a friction feeling) under the scar in my palm area. The part right under the tip of my thumb (not sure what that is technically called) seems to be really scarred down and hard and I am pretty sure that is where it is getting caught up... No matter how much I massage that area, it doesnt seem to do anything... Massaging it almost seems to make it worse unless I do it extremely light.

    I am very optimistic that the ultrasound is going to be the way to go to break the tendon free from the scarring... they asked me to come in 3 times a week to do this... at 25 bucks per co-pay, plus the time off work it seemed more beneficial to buy an at home ultrasound. I bought one online for $100 - I am going to start doing that at least once per day at home... it should be arriving tomorrow. I will still probably go 1-2 times a week to have them do it as well as hand therapy sessions. I would definately recommend asking to do ultrasound over the scarring if they haven't started that already and see if it helps you. I noticed an immediate difference!

    As far as not wearing a splint at all times, like I was told to do, at this point (4 weeks out), I am not sure I agree. It seems as if I have way more flexibilty in the morning right when I take my splint off after wearing it for 8 hours... I think it allows that imflammation to calm down. When I have no splint on throughout the day and try to bend the tip and hold and constantly excersize it, it gets stiff and seems swollen... to the point that I am unsure if the tendon is still attached because it doesn't seem to be moving at all. There really seems to be a fine balance... I was told to push the therapy/excersizes hard, but my personal opinion is to go real light, but constanstly excersize and massage the area until the swelling seems to subside - then push it hard.

    I hope yours is improving nicely...



    Quote Originally Posted by Codecruncher View Post
    I'm 3 weeks post second stage tendon graft surgery today.

    I've noticed that my surgeon and PT people are generally more aggressive in their approach than any of yours. Maybe that's because my injury was thumb vs. fingers - or maybe he just moves faster. Examples:

    1. My hunter silicon stage 1 was only in for 8 weeks (and he was suggesting a range of 6-8 so I was on the long side). Sounds like all of you are closer to 12-16 weeks. Bonus: I got to keep the rod to see up close what was in me for all that time.

    2. At the urging of my surgeon since I scar quickly, PT had me doing place and holds on the thumb after stage 2 the very next day after surgery.

    3. My surgeon considered buttons "old school" and rarely uses them unless there is almost nothing left to connect the tendon to.

    4. They have me getting out of the splint for periods at my desk - like typing. But typing doesn't use my left thumb at all (I took formal classes way back in high school). I find I do a lot more PT a lot more often when in meetings or just at my desk if I'm not in the splint.

    I hope this approach works for me - not sure at this stage if it is better or not; just different.

    Like any health related issue, I find that I need to research outside of my doc and PT visits and come to them armed with lots of questions. I get the feeling that other patients don't take that much effort/investment in their own recovery.

    I don't think lots of PT makes it harder to gain back flexibility so far. I do take Ibuprofen afterwards to try to minimize swelling and irritation.

    I continue to see small improvements so I'm quite positive and just trying to remain patient with the 3-4 month recovery time.

  10. #60
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    Hi Online2,

    Glad to hear things are progressing for you and that you have not re-ruptured!

    What area of the country are you? I'm in Madison, Wisconsin. My OT person is really curious - I've shared all these other experiences with her - she thinks people have this perception that the midwest is lagging in progressive treatment plans, but when she has compared at conferences, she has concluded we are often pushing the envelope more than the coasts.

    Do you have a link to your ultrasound device? I'm very interested. I purchased my own paraffin bath unit to maximize my therapy (Amazon link is back a few posts) - maybe ultrasound is another good option. I use the bath 3x a day.

    Your experience of flexibility is opposite to mine. I'm the most stiff right away in the morning and get better throughout the day. My OT person thinks you are correct - you are probably over doing it a little and pushing things into inflammatory areas.

    I did my first ultrasound for this round on Tuesday 4/29 and again today. I have seen slight improvement, but have not felt friction or more freeing as you indicate yet. I also have not been wearing my splint much at all the last week, but have been very careful with that hand. I find I do OT a lot more throughout the day when the splint isn't an immediate obstacle (10 minutes here, 5 minutes there, sitting in a meeting, etc.). And the continual slight movement has got to be helping avoid total scar down I figure.

    After paraffin, massage, and exercise my thumb tip range of motion is about 2 centimeters total (more of that is extension than flexion, but it clearly is still connected - I had zero before).

    I am fairly aggressive at scar massage, stretching, and exercises. I don't find that anything I do so far has caused me to swell up.

    I also have a little very sensitive pressure point just past my IP joint in the pad of my thumb - almost the opposite side of where my thumb nail is. That sucker is pressure sensitive. That was where my hunter rod ended and where the sutures must be to attach the transplanted tendon to my remaining FPL stump distally. Light massage has helped, but I think it is going to be pressure sensitive for a long time.

    Today my OT reformed my previous splint into a night time stretch one that sounds identical to what you have now (pics below).

    In addition, I discussed stretching during the day with my OT and we came up with a new idea using a foam roll to try to restore thumb extension vs. flexion ("thumbs up" as you call it). See the pics of my red foam roll below. I stick a small ball point pen inside it to add stiffness so it continues to stretch and not collapse in the middle. But the foam softness really helps against that pressure "point" in the tip of my thumb - it doesn't aggravate it like a hard surface does.

    My scars have healed very well - same as previous surgeries. The thumb scar you can't even see anymore, the wrist is still a little more dramatic.

    My wrist extension is responding well. I could barely get to neutral 2 weeks ago and now I'm doing much better - maybe 1/3rd of the way to normal range of motion by the end of a therapy session.

    The wrist is loosening a little also - not quite like a rock. The incision line itself is still very stiff, but to the right and left it starts to be pretty pliable quickly.

    Best of luck. Sounds like we are both progressing about the same.

    Finger tendon graft surgery, off the bike for a while-img_1355.jpgFinger tendon graft surgery, off the bike for a while-img_1356.jpgFinger tendon graft surgery, off the bike for a while-img_1359.jpgFinger tendon graft surgery, off the bike for a while-img_1361.jpgFinger tendon graft surgery, off the bike for a while-img_1360.jpg

  11. #61
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    CodeCruncher,

    Thanks for sharing those photos - your scar in your wrist seems to be doing MUCH better than mine... Mine is still red around the incision and a bit swollen (I will try to get some pictures up here soon). Those parrafin baths look like they work!

    I bought the US PRO 2000 portable ultrasound machine off amazon.com - not too sure if it is helping, or not, but I figure it cant hurt. I am using it once to twice per day for 10 minutes. I have not felt a significant change at home with that device or at PT with their device since my initial ultrasound treatment where I felt the friction feeling of the tendon gliding in the palm area. That friction feeling has also gone away.

    I have not been wearing the splint (except at night to get the extension back) as instructed and have been finding myself trying to do PT excersizes any chance I get during the day as well....

    I am only getting maybe 1-2 centimeters of movement when I try to wiggle the tip of the thumb... I haven't gained much movement since the surgery.

    When I do a place and hold, I can hold it for 5-10 seconds at around 2-4 centemeters, but then it goes back up without my control, no matter how hard I try to keep holding it there. Does that happen with you?

    PT has been going OK - they have told me they don't want to start getting "aggressive" until 6 weeks, which is next week.

    When you make a fist, does your thumb bend in at all, or does it stick out straight? What has your doctor told you about possible recovery time and possible range of motion to expect?

  12. #62
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    Hey all, thought I would jump in with a quick update of my situation.

    I am now 11 days away from phase 2 surgery on the 21st (can't come quick enough!) and as of now things are going fairly well. My "custom" Hunter Rod job is still holding up and I finally remembered to grab a photo of it:

    Finger tendon graft surgery, off the bike for a while-img_20140508_112757.jpg

    The only cause for concern is that there is an internal suture that somehow got trapped partly exposed out of the skin when they sewed the incision shut and the skin hasn't healed fully around the area. My doctor says as long as its not infected, it should be fine, but I haven't been allowed to get the hand wet at all for the last two months!

    Other than that, I have been taking it easy and just sitting around on the couch. Starting to pack on a few pounds because my beer drinking hand is still fully functional

    Hope you all are doing well.

    J

  13. #63
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    Great to hear from jminus and online2!

    jminus - at least your 12oz and 16oz curls are maintaining muscle tone in your unaffected hand . Bummer to hear about your suture exposure - that sucks. We both know how awesome a real shower is after ~12 days and you're still having to do the garbage bag dance every day - I feel for you! I hope that area of non-healing doesn't present any complications on the other side of stage 2 for you.
    Best of luck on your upcoming stage 2 surgery! It will be your last one - just like us!

    online2 - my OT people freaked a little when I told them you bought your own ultrasound. They were concerned you'd use it too much and there are a lot of different time and frequency settings they choose to aim at different results. Hope it works out for you - be careful and keep your OT informed on what you're doing. Buy the paraffin bath - you'll love it. It is awesome for just general OT and you can always sell it later on craigslist. I think I'll keep mine as it will really help with finger cracking during our dry Wisconsin winters.

    My place and holds were best right after surgery. But in the past 5 weeks I am not able to keep it in place as well. But the behavior is different. As soon as I release my hold, it pops up a little and then I can sustain the position indefinitely.

    I'm clearly scarred down some as my extension is still hampered, but my MP joint works fine if I put the tendon on slack and bend it. I've been trying to keep on the scar massage and watching lots of youtube videos on myofascial release, scar tissue massage, etc.

    My night splint and the red "spacer" rod are working, but very slowly. I get a little bit more, but it feels like it is approaching plateau in a battle against scar tissue.

    In contrast, my wrist extension backwards has been progressing fantastic. Once all warmed up, I am within about 20% of normal I'd estimate. That should get me out road biking in a couple of weeks as wrist extension ability was the primary problem preventing gentle riding.

    Next week (week 6) I expect my OT will start iontopheresis for 5-6 sessions. Have either of you had that previously? I had 6+ sessions of that last fall, but that was after I was unknowingly ruptured so of course it really had no positive result.

    Here are a few pictures of wrist and as much tendon excursion as I'm able to after a home OT session.

    What area of the country are you folks in?

    Finger tendon graft surgery, off the bike for a while-img_1368.jpgFinger tendon graft surgery, off the bike for a while-img_1369.jpg

  14. #64
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    Hey everyone, I finally had my phase 2 surgery yesterday so I thought I would check in.

    Everything went well. The doctor tried to use the plantaris tendon (Plantaris muscle - Wikipedia, the free encyclopedia) in my right leg for the autograft, but it wasn't long enough, so he used of my toe extensors instead. Unfortunately, the only way to check the plantaris is to remove it! Kind of strange to have a body part "wasted", but I knew that was a possibility going in. I haven't seen it yet, but I had the button installed on my finger. I will try and get some picts at my next appointment. I will start PT on sunday.

    I did get some good news. Apparently the original muscle belly for one of my index finger flexors was intact enough for my surgeon to use. This means I will hopefully retain more independent motion for that finger once recovered. I have my fingers crossed (har har).

    So, here I am, with my hand AND my leg in splints, laying on the couch typing with one hand for the 4th and hopefully last time. Hope you all are doing well.

    Justin

    PS - just ordered a slew of bike parts as a reward!!! My shopping/beer hand is in fine shape.

  15. #65
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    Best of luck jminus! Did you not have an extra palmaris longus in your forearm to use? My doc said about 85% of people do, but maybe you fell into other group? Or perhaps those are not long enough for your finger need vs. my thumb.

    I hope your surgical site heals well and that you have no complications from your suture exposure that didn't close up well from previous surgery.

    I'm 7.5 weeks after the final graft surgery. My PT continues, but I'm starting to worry that I'm plateauing in function. I actually had more range of motion when the FPL was ruptured between surgeries 1 and 2 because I could extend fully. Now I'm in this middle range where I cannot extend fully because it is attached, but I also cannot flex fully because of scar tissue. I continue aggressive stretching and PT, but I'd love to see some stronger results to encourage me in a positive feedback cycle.

    Best of luck and please continue to update on progress.

  16. #66
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    I do have the palmaris longus, but the doc said it wasn't long enough. I guess he needed about a foot of graft.

    I have been doing the place and hold exercise since friday 4x a day for 10 minutes (2 days post op). I can feel the tendon moving inside the new pulley system... it is sort of sticky, like it doesn't have any lubrication. Not sure if that is expected at this stage or not, but at least I know it is moving and still attached.

    Leg and hand are both pretty sore and I can't really walk. Still taking some PKs at this point, but only a few each day.

    Sorry to hear you progress has stalled a bit. Maybe with continued PT you will break through some of that scar tissue. Do you have any power in flexion? I could live with less ROM if I at least have some strength back in the finger. I already have about 20 degrees of contracture post surgery. The doc said that he intentionally hooked it up tightly because he expects it to stretch.

    J

  17. #67
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    I do have some power in the flexion. I just unloaded the dishwasher for example and can finally grasp a mug or cup from the bottom up side down and pull it up with just the tip of the thumb used (vs. the "lobster claw" sandwich move I used to have to do).

    I started strength exercises with putty about 1.5 weeks ago. Those are definitely helping, but at this stage only 7.5 weeks since surgery my grip is nowhere near what it was pre-injury of course.

    Glad to hear you're moving it passively already and are out of the surgical dressings enough to do that. I think that was a big hindrance on my first surgery where I was stuck in the dressing for 4.5 days with zero movement.

    How's the swelling? Are you still icing it?

  18. #68
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    There really hasn't been much swelling. I never iced it as I wanted to encourage as much blood flow as possible. Instead I just keep it elevated most of the time. Today, I'm trying to take ibuprofen instead of the PKs in the hopes that some anti-inflammatory meds will reduce the stiction in the tendon sheath.

    I have a bit more extension this morning as a result. I'll see the doc on Friday to get an official status report.

    At 7.5 weeks, what are your restrictions? I assume you aren't allowed to do any heavy lifting right? What kind of timeline have they given you?

  19. #69
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    Sounds like you are in a good place. Hope your leg heals fast - that has to be a huge obstacle compared to the previous surgeries where at least you could walk around easier.

    I have no restrictions basically - I avoid lifting anything heavy or really, really straining it, but I'm so concerned about the scar down that I've been stretching it pretty aggressively for at least a few weeks now - and I stopped wearing the day splint after 2.5 weeks. Timeline is pretty open now. They are hopeful continued iontopheresis and ultrasound and OT will break up the scar tissue and get me more excursion and ROM. Surgeon said it would be a year or two before I really know where I end up in terms of function. But if I'm dramatically impaired to where a tenolysis is a possibility I'm sure that would be about 6 months or more after the April 2nd surgery - so Oct or Nov at the earliest. I really want to avoid that so I've been hammering OT hard.

    The site up my forearm near the elbow where they took the palmaris longus ended up with a large hemotoma - felt like a large solid peanut M&M under the skin. For the past 7.5 weeks I've been really aggressively mashing on it with a plastic massager tool and it has really responded. I'm confident I'll be able to get rid of the entire large rock lump completely. If you have something similar in your leg, might want to do the same.

    The plastic massager tool I have is great. My wife got it for a hip labral tear she had repaired. My right hand (the good one) gets soooo tired trying to constantly massage and exercise the injured left hand. The massage tool helps me from trashing the right hand and getting tendonitus. Below is a quick picture of it.

    Hey - the upside of the paraffin bath you bought is you can use it on your foot! That will help those scars heal much quicker.

    I hit a huge milestone tonight - one that I'm confident you will enjoy soon. I went road biking with my large group of regular Wed night riding friends. Did 30 really hilly miles on a gorgeous night. Super happy. Boy does my ass hurt (10+ months off the bike).

    What state are you in? My OT keeps bugging me on where you are - she wants to "compare" to the coasts I think. I'm in Madison, Wisconsin.

    Finger tendon graft surgery, off the bike for a while-massager.jpg

  20. #70
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    While I am from the west coast (Washington), I am currently in NYC and my doc/ot are from the Hospital for Special Surgery in Manhattan.

    Congrats on the bike ride! 30 miles seems pretty good for a first ride after that long off the bike.

    I'll look for a massage tool like that, although it just occurred to me that I could probably use a metal bike tire lever to do the same job

  21. #71
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    Just had my doc appointment. Everything on track, no real concern about the "stiction" in the tendon glide, but they do want me to back off on the amount of place and holds. Also told me to minimize/cut out the ibuprofen, as it can hurt the soft tissue healing. I didn't know that.

    Current timeline is:
    - Stitches out two weeks post op (next thurs) and I can take a (bag over hand) showers again and hopefully wear a shoe on my right foot.
    - Button comes off after 6 weeks post op. (Yay garbage bag showers)
    - No two handed typing and splint stays on for three months post op (not 100% sure this is what he meant)

    Here is a picture of the foot carnage.

    Finger tendon graft surgery, off the bike for a while-img_20140530_111540.jpg

  22. #72
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    Wow, you picked a good adjective on that one. That is a few more stitches on the foot than I would have guessed. Hopefully it heals quickly and the swelling reduces.

    Is the back side of your calf on the same leg also opened up that much where they tried for the plantaris tendon that ended up being too short?

    re: Ibuprofen - I've heard concerns if bone is involved in the healing, but not on pure soft tissues before. But a few google searches do indicate definite questions around it.

    My thumb extension stretching is progressing a little more. I got a little too aggressive the other night with the dicem anti-slip patch in trying to pull around any scar tissue and managed to inflame the incision line a bit. But backing off on that has let it heal again.

    Best of luck - later this week is stitches out for you - always a great milestone day.

  23. #73
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    Wow Justin! Your foot made me greatful that I had the spare tendons in my arms. I wish you a very speedy recovery!

    I just wanted to provide an update, I believe that I am the farthest out from Phase 2 surgery. I had phase 2 approximately 4 months ago, and I'm nearing the end of my PT sessions as well. It has been a huge adjustment for me mentally, as I did not receive the results that I expected.

    My little finger on my right hand now bends when the other four come down, but unfortunately I am still unable to make a fist because my fingers do not work in tandem. Apparently the new tendons are shorter than the old ones significantly, so that the tips do not all curl over at the same time. I can bend the tips of my unjured fingers separately, but they all do not bend together in the correct motion that would allow me to make a fist - which is very disappointing. My pinky finger is also bent in an awkward position, the tip is really stiff - even with using the night time splint so I am unable to lay my hand flat. Its a very uncomfortable feeling that I'm hoping I will notice less in time.


    I didn't really want to update because I didn't want you all to compare your results to mine, but it feels relieving talking to others who are going through the same thing. I've attached some pictures of my progress.
    Attached Thumbnails Attached Thumbnails Finger tendon graft surgery, off the bike for a while-image.jpg  

    Finger tendon graft surgery, off the bike for a while-image.jpg  

    Finger tendon graft surgery, off the bike for a while-image.jpg  

    Finger tendon graft surgery, off the bike for a while-image.jpg  


  24. #74
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    Quote Originally Posted by Codecruncher View Post
    Is the back side of your calf on the same leg also opened up that much where they tried for the plantaris tendon that ended up being too short?
    Fortunately, the back incision is much shorter. A week on from my last post, I am walking much better and things are starting to feel closer to normal. I have all the stitches out now, but I am dealing with a few minor skin issues related to healing that are annoying but not very serious.

    Haven't started working on extension yet, looking t my finger now, I'm guessing that it is going to be a challenge to get it to straighten out.

  25. #75
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    Nonbiker,

    That must be frustrating to be so close to "normal", but not quite there. Does your doctor/OT expect any progress in the future?

    I may be dealing with a similar situation, as my tendon is "tight" as well. My doc said that he expects it to stretch out over time. I am also seeing some minor bowstringing in the base of the finger at the A1/A2 pulley area. I almost feel like it has stretched a bit. Basically, I can see/feel the tendon through the skin, though I don't know if it is going to be an issue. It could simply be that my rebuilt pulleys are looser than the original.

    I also had another exposed suture! For some reason my body wants to spit them back out. The doctor trimmed it off, but if the skin doesn't heal, I may be in for yet another (minor) operation to close it up! Ugh. Hopefully, it heals on its own.

    Here are a couple of shots of the current situation. The second photo is where I can "hold" the finger when I fire the muscle.

    Finger tendon graft surgery, off the bike for a while-img_20140613_092656.jpg
    Finger tendon graft surgery, off the bike for a while-img_20140613_092807.jpg

  26. #76
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    Wow jminus - that looks great (save for the exposed suture part). Your flexion with the hold looks good to me and the swelling doesn't look to bad. How's the extension so far - I don't suppose they have you trying much of that yet so it must be pretty tight still.

    Nice that they didn't have to open your finger and palm up again - looks like it was just at the top two joints and then down past the wrist.

    How's the foot and calf healing up? I suppose in NYC you aren't driving much anyway?

    When do you get the button removed? I assume you still can't get that portion wet?

    This Wed will be the 12 week mark (3 months) for me and the thumb. I'm still getting iontopheresis with the potassium iodide on both the thumb near the MP joint and that pulley and the wrist tendon bundle. Both I think have responded well to it - they are definitely much softer and more pliable and I think I'm getting slightly more movement. The night splint really didn't do anything for me anymore and they've got me using a little spring single finger splint for an hour or so at a time throughout the day for a gentle, but long continuous stretch at this phase. I think my 12 OT visits covered by insurance run out this Tuesday so might be on my own after that; we'll see what Tuesday's visit brings. I feel I can do all the same OT on my own; the only thing I really think the appts were needed for the last 3-4 weeks was the ionto treatments.

    I've gradually gotten a little more extension and it feels like the tendon is catching or starting to loosen a little more in my wrist (feels different the last week or so) - maybe the ionto is finally busting that rock of scar tissue and adhesions up more.

    I've been able to bike for 3-4 weeks; did a few 35 hilly mile most-of-the-day casual road bike routes and the wrist and fingers tolerate all that well.

    Day to day life is fairly regular - I don't think about the hand that much - except my pinch strength and grip strength isn't anywhere near what I'd like yet. But I've just started in the last 2 weeks on major strengthening exercises so I think that will come around a little more - obviously if the tendon glided as good as it originally did it would be better at transferring the forearm muscle strength contraction to the finger tips for increased pinch/grasp strength. I'm hopeful that continues to gradually improve with daily work the coming 4-6 months.

    Wow - am I tried of doing OT every day. I'm sure you are burnt out at times on it also. Will be so nice to just go back to regular life and get back that 90 minutes or more a day of messing around with your hand.

  27. #77
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    Had my final OT checkup today at 4 months.

    Pinch strength is very close to normal and the grip strength continues to improve with exercise. The IP joint has some contracture compared to before when it was very hyper extendable. I can do a pretty decent Fonzi thumbs up move and continue to work on that stretch.

    I'm just spontaneously using the hand normally for just about everything and continue to try to do OT, mostly stretch and strength - and a little scar massage still - but I'll skip a day or two if I'm too busy with life.

    Best of luck to everyone. Life does get a lot better. August 6th will be my 1 year injury anniversary.

    I even got to hike up to the top of Mt. Fuji in Japan earlier this month with hiking sticks and had no issues!

  28. #78
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    Codecruncher,

    Good to hear from you! I'm glad to see things have been going well. Sounds great to be back to full activity level! I'm really looking forward to that for myself.

    I have been meaning to give an update on my situation:

    I am exactly 10 weeks out from phase 2 surgery today. I had the button taken out several weeks ago and I am back to taking showers without a bag! The suture issue seems to have healed up, though there is a little "thin" spot in the scar tissue there and I am having to monitor it closely.

    My doctor and OT have been very conservative with my OT program due to my history of failures/complications, so I am still wearing my brace when in public and at night, though not while in the office or at home. I am also wearing a brace to straighten the finger at night and a ring to support the A2 pulley area during the day. I am also allowed to use all my fingers for typing again (yay!) and things feel pretty normal form a work perspective.

    My OT protocol currently involves active motion: trying to straighten the fingers with wrist flexed backwards and then closing the fingers into various bent positions. When I try to make a fist, I can get pretty close, though I can't quite get the finger down to the palm. My ROM there has been pretty static for several weeks, though I am happy enough with it. I have some bowstringing through each rebuilt pulley, so I probably won't get too much improvement here due to the lack of mechanical efficiency.

    For extension, I have about a contracture of about 25 degrees at the second knuckle. I am still seeing continued improvement in this area with the night splint and daily OT stretching. Even so, I am pretty happy with the current ROM.

    My only real issue with the finger is that the tendon does not glide smoothly across the pulleys in certain positions. I hope this resolves itself in time. We will see.

    I will be finally starting resistance exercises tomorrow in my next OT session. Should be interesting. I think they will have me in the brace for a full 12 weeks.

    On the more negative side, I am having some complications with my foot where they removed the graft. I actually was cleared to start running last week, which felt great. Within 4 runs I was getting close to my pre-injury mileage. But after my run on Monday (4.9 miles!) I noticed that something didn't look right with my anterior tibialis tendon. Basically it is bowstringing out pretty severely when my foot is in dorsiflexion. It could be related to over compensation from losing part of my EDL (which is still scarred down and not moving) but I'm not happy about it either way. It doesn't really hurt (yet) but I'm quite frustrated to have my previously healthy foot now being a source of problems.

    I ordered an ankle brace and I will back off on the running and see what happens. I am pretty determined not to have another surgery, so I am hoping it is something I can manage with therapy. At least walking feels

    I'll check back in once I have some more news.
    Here is the current state of affairs:

    Finger tendon graft surgery, off the bike for a while-img_20140730_094858.jpgFinger tendon graft surgery, off the bike for a while-img_20140730_094906.jpg

  29. #79
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    I want to thank jminus for starting this thread, and everyone else for participating providing insight that I can apply to my very slow healing process after crushing a middle fingertip in a door seven months ago.

    As a guitarist, I know I was very lucky; I lost no function (only the nail). However, the bone is still quite tender, and playing normally is impossible for more than a few minutes a day. So I understand the challenge of having to wait seemingly forever to get back into action, much less full performance.

    I'm also a swimmer. If any of you have done triathletics, you may know the benefits of swimming, even if it isn't your favorite sport. While it's not much of a weight-reducer, it might help balance the 12- and 16-ounce toning mentioned earlier and help regenerate both stamina and upper body strength lost during the long recuperation process - all this while being easy on bones and soft tissue.

    Of course, you have to be sure that suture points are pretty well sealed, as even the most chlorinated (yechh) water poses risks to deep wounds.

    Anyway, I wish each and every one of y'all the best results possible, and thanks again for making my journey a little easier.

  30. #80
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    That's great progress jminus!

    Your index finger contracture is just slightly more than my thumb and you haven't really started aggressively stretching it so I'll bet it improves a bunch.

    Bummer to hear about your potential calf complexities, hope that is a short term reaction as your body figures out what new muscles need to be toned up in order to deal with the re-configuration of things.

    Aren't normal showers grand?

    You hit a low point on the first failure of the hunter rod, but seeing you be able to flex all your fingers into a fist is fantastic. It sounded like you were close to just living with it ruptured, but despite all the challenges, having even the function you have today is so much better.

    Best of luck!

  31. #81
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    Hi everybody, I had been in this forum back in Feb/Mar 2014 as I had 2 FDP ruptures from an incident at work (Sheet Metal). I had planned on it anyways but my Surgeon also asked me to join some forums and share my story with people.

    In February I had cut all 4 fingers on my right, dominant hand. I was on a remote worksite but was rushed to the small town hospital. I was checked out and was assumed to not have any tendon damage and that my loss of motion was due to pain so I was stitched up and sent home to follow up with a specialist. 2 days later I went to the hospital and got referred to the specialist the next day (order of operations in the health system). So naturally with the other doctors opinion he didn't think know for sure if there was a problem so he wanted me to get an ultrasound. So I went to OT right away and they put me in a brace to keep tension off incase they weren't ruptured and so they could heal. Ultrasound took 2 weeks to get into and found that my index and middle fingers had FDP ruptures. So followed up with my surgeon and between him and Ot they said its too late to try a repair so I got booked in for surgery 2 months later- April for the 2 stage hunter rod. I did lots of warm water soaking and passive motion the whole time and my fingers were passively moving great. I stayed off the beer and ate as healthy as I could to give my body the best chance possible. I went in for surgery and the surgeon was able to feed my tendons back through the sheath and reattach!!! I was so excited and my OT was very surprised! I started Physio two days later doing passive motions in a mobile splint to restrict my movements. I went through this process for about 6 weeks, starting place and hold about halfway through, and then started very light strengthening. The soaking and suture stage sounds about the same as everyone else. I was working my way up through the strengthening levels and at week nine my middle finger re-ruptured on a pinch strength excersise. I was Devastated. Still not sure why, may have been pushing it too hard, may have done something at home that pushed it too far? But so I had now planned to do a hunter 2 stage on my middle finger. This time I got in 4 days later (would've been 2 but they could not find the rods or ran out). I asked my surgeon if he could work his magic again PLEASE. He was very doubtful and so was I then. But then I woke up and asked if I have a rod in my finger.. he smiled and said no. He was able to do it again! So we co-ordinated with physio and I started a slower cycle. I was bound to my brace and 0 active or place and hold for 3 weeks. I had a follow up with my surgeon and he recommended starting active motion, so my OT started my on place and hold for about another 3 weeks and finally some straight active motion. I was being very careful and limiting the amount of any movement I did outside of physio. at about 2 1/2 months I started strengthening again and also doing passive and active motions. I was doing modified work 8 weeks after my second surgery and it was amazing watching my progress as I could lift more and more. and I am just now, 10 months later, going back to my normal duties. I do have a lag in my middle finger that I will continue to work on and a slight lag in my index and I also have some loos of sensation in my index finger. I know this is a different scenario than any of the posting on this site already but I figured it could give hope to anyone who comes across it. For a guy who was never to do construction again ive already been swinging a hammer, squeezing snips and wire cutters and using power tools. My strength is great and is still coming back as I proceed with everyday life. Im not suggesting to fight for re-repairs as I did, I'm just trying to let people know to do as much as you can to help the healing along, don't neglect it.. but don't push it too hard! I know its a fine line and can be difficult, but just do what you are comfortable with. As much as it doesn't seem like things will be at the beginning, everything will be ok and you will get better/adjust and carry on with life!

  32. #82
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    hello, I just had a rupture of my fdp tendon (jersey finger) of my dominant hand and was told because of the tear the tendon is now much shorter, the tendon ended up in my wrist. I went thru the procedure to reattach it to the dp joint with a hole drilled thru the bone and sutures. the tendon was cut shorter because of how much it was shredded. Now he wants to open me up again and do a tendon lengthening procedure because I now have a condition known as quadrigia. he wants to do this procedure in the bottom picture, I wanted to ask others this as well, no one mentions pain that much , I am now 5 weeks into this and the pain is still intense and the surgeon said its because of my shortened tendon is pulling more than usual, I know about pain I ruptured my achillies and after 5 weeks I was wearing both of my shoes and not much pain at all and this is much worse . what do you think
    Attached Thumbnails Attached Thumbnails Finger tendon graft surgery, off the bike for a while-img_20141123_134058_351.jpg  

    Finger tendon graft surgery, off the bike for a while-img_20141123_133535_660.jpg  

    Attached Images Attached Images  
    Last edited by jdh022764; 12-20-2014 at 03:01 PM. Reason: attachment

  33. #83
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    jminus, which tendon failed? fds or fdp? are hunter rods designed for both or only one of the tendons? and why couldn't the surgeon just reattach it again

  34. #84
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    Quote Originally Posted by jdh022764 View Post
    jminus, which tendon failed? fds or fdp? are hunter rods designed for both or only one of the tendons? and why couldn't the surgeon just reattach it again
    Both the FDS and FDP tendons were initially severed when I cut my hand. My first surgeon was going to try and reattach both, but told me after the surgery that the damage was to extensive and he could only get one re-attached. It didn't matter, because the primary repair ended up failing, hence the need for the hunter rod.

    I don't think it is possible to replace both the FDP and FDS using the hunter rod procedure. By that point, they will just do the FDP since it can perform most of the work of the FDS as well.

    As far as your situation, it never hurts to get a second opinion. I have read about the tendon lengthening procedure, but I don't know anyone who had it done or what the consequences are in terms of tendon strength. I would probably opt to have it done rather than live with a severe contracture. I have a mild contracture (10-15 degrees) and I think it is really annoying. Probably not annoying enough to have it fixed, but if it was much worse, I would.

  35. #85
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    I have a severe contracture but the quadrigia is the main reason we are talking about the lengthening procedure. when I ruptured my tendon my adjacent fingers worked perfectly now they do not and he said its because of the quadrigia from pulling the 5th digit tendon to reattach it and now the other fingers have slack in the fdp tendons, what a pain in the butt this turned out to be.

  36. #86
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    Quote Originally Posted by jdh022764 View Post
    I have a severe contracture but the quadrigia is the main reason we are talking about the lengthening procedure. when I ruptured my tendon my adjacent fingers worked perfectly now they do not and he said its because of the quadrigia from pulling the 5th digit tendon to reattach it and now the other fingers have slack in the fdp tendons, what a pain in the butt this turned out to be.
    Hi sorry to hear what you are going through. I also had the hunter rod replacement surgery. My second surgery was in Feb 14. I have contracture in my finger that really bothers me - its more than just annoying its painful, and while I have good passive motion, my action motion is not great, and my two fingers that were fixed surgically move at a completely different pace than the three that weren't. I went to see another specialist who said that the fix could be worse than the problem - meaning that I should essentially live with it. Its had me pretty down in the dumps. I'm not sure I'm better off from where I started. Anyway, wish I had better news - wishing you the best of luck!

  37. #87
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    Quote Originally Posted by nonbiker View Post
    Hi sorry to hear what you are going through. I also had the hunter rod replacement surgery. My second surgery was in Feb 14. I have contracture in my finger that really bothers me - its more than just annoying its painful, and while I have good passive motion, my action motion is not great, and my two fingers that were fixed surgically move at a completely different pace than the three that weren't. I went to see another specialist who said that the fix could be worse than the problem - meaning that I should essentially live with it. Its had me pretty down in the dumps. I'm not sure I'm better off from where I started. Anyway, wish I had better news - wishing you the best of luck!
    Nonbiker,

    Have you been wearing a night brace to straighten the finger out? I have found that it seems to really help. My contracture has definitely improved over the last few months. I still wear the brace every night. My whole hand and wrist is weak and has lost a lot of flexibility, so I think this will improve over time as I return to regular use.

    My biggest issue now is that the finger doesn't feel "right" when I grip things or move it. Lot's of twinges and little pangs, sensitive skin, etc. I'm paranoid that the repair will fail as soon as I do anything strenuous, especially given the track record I have with complications and failures. I've already made the decision that if it does fail, I'm not going to get it fixed again and either get it removed or just live with it.

    I've come to accept (and appreciate) the level of functionality that I have now, but I don't want to have to baby my finger for the rest of my life.

    I'm slowly phasing in heavier activities. I've been using the hand in the gym with light weights and I plan to go on my first (easy) bike ride this weekend. The doctor said I am to have no restrictions by Feb 25th... 9 months after my stage 2 repair.

  38. #88
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    Just a quick visual update for anyone who comes across this thread.

    My finger gets pretty close to straight and I have pretty good active motion. I'm fine with the current state of affairs, IF it holds up under heavy activity We will see, I'm starting to ramp things back up.

    The best part is not wearing the damn brace. I got SO TIRED of explaining what happened over and over again for a year. It has given me a new appreciation for what somebody with a visible disability must have to live with.

    Finger tendon graft surgery, off the bike for a while-img_1015.jpgFinger tendon graft surgery, off the bike for a while-img_1016.jpg

  39. #89
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    Quote Originally Posted by jminus View Post
    Nonbiker,

    Have you been wearing a night brace to straighten the finger out? I have found that it seems to really help. My contracture has definitely improved over the last few months. I still wear the brace every night. My whole hand and wrist is weak and has lost a lot of flexibility, so I think this will improve over time as I return to regular use.

    My biggest issue now is that the finger doesn't feel "right" when I grip things or move it. Lot's of twinges and little pangs, sensitive skin, etc. I'm paranoid that the repair will fail as soon as I do anything strenuous, especially given the track record I have with complications and failures. I've already made the decision that if it does fail, I'm not going to get it fixed again and either get it removed or just live with it.

    I've come to accept (and appreciate) the level of functionality that I have now, but I don't want to have to baby my finger for the rest of my life.

    I'm slowly phasing in heavier activities. I've been using the hand in the gym with light weights and I plan to go on my first (easy) bike ride this weekend. The doctor said I am to have no restrictions by Feb 25th... 9 months after my stage 2 repair.
    I have not been wearing the brace at night anymore. At this point I am 11 months post phase 2 and my doctor said that its not necessary anymore. Sometimes I wear the finger splint with the spring (can't remember what its called) to straighten it out a bit, but as soon as I use my finger it bends back.

    I'm happy that your finger turned out well. Looks like you have great active motion from your picture below. I know what you mean about your finger feeling foreign. Mine does too as well. I don't think that you tendon will pop again. From what I understand it is very strong, and the likelihood of that is very low at this point unless perhaps you fall directly on top of it.

  40. #90
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    Thank you jminus for the response, I had my second surgery January 14, 2015 to release the FDP tendon with the Z-Plasty technique and 12mm was added in length. when I got out of the cast two weeks later the only difference I saw was the finger being slightly straighter and it does not work still. if anyone out there can tell me what I can expect from this please let me know, I did some therapy after my first surgery but my hand and finger was so swollen that it didn't do much and because of the over advancement of the tendon the pain was intense for the two months after. One thing that the 2nd surgery helped was the pain was gone except for the incisions again.

  41. #91
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    Figured I should follow up now that I am FINALLY back on the bike. I moved from NYC to Washington State last week and the weather here was already in full-on spectacular MTB mode. I am currently living out on the Olympic Peninsula and working from home which means I can hit the trails every day at lunch!!!

    So far I have been on 5 MTB rides (and one ride with the roadies) and things are feeling pretty good. I can actually do one-finger braking as well. My hand still feels weak and sore, but I think it is starting to improve.

    I can't even describe how great it feels to be riding again. Looking back on my original post makes me cringe. 1 year and 5 months off the bike. LAME! At least I stayed in decent shape by running and hiking.

    Hope the rest of you have your lives back as well.

    Take care,
    Justin

  42. #92
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    Hi Justin,

    Man, i read through your story.....You are warrior!!!

    I tore the FDP in the ring finger of my left hand on 3/3/15 (6 weeks ago). it was a complete rupture.

    The surgeon operated 3 days after initial injury on 3/6/2015

    I am now 5 and 1/2 weeks post-op

    Been doing hand therapy 2X/week

    I'm concerned.....not much flexion in the DIP of the repaired finger.

    The therapist keeps telling me that i've adhered/scarred and thats why the tendon is not pulling through.

    Can you offer any advice? This whole ordeal has been very difficult emotionally like you I'm an athlete who's weekly regiment incorporated bike, swim, hike, yoga, cross-fit.

    The only thing i can do now is spin inside.......

    thanks for your input,

    Eric in Oakland

  43. #93
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    Quote Originally Posted by bankstoneric View Post
    Hi Justin,

    Man, i read through your story.....You are warrior!!!

    I tore the FDP in the ring finger of my left hand on 3/3/15 (6 weeks ago). it was a complete rupture.

    The surgeon operated 3 days after initial injury on 3/6/2015

    I am now 5 and 1/2 weeks post-op

    Been doing hand therapy 2X/week

    I'm concerned.....not much flexion in the DIP of the repaired finger.

    The therapist keeps telling me that i've adhered/scarred and thats why the tendon is not pulling through.

    Can you offer any advice? This whole ordeal has been very difficult emotionally like you I'm an athlete who's weekly regiment incorporated bike, swim, hike, yoga, cross-fit.

    The only thing i can do now is spin inside.......

    thanks for your input,

    Eric in Oakland
    Ouch, ring finger. I'm sorry to hear that. My only advice, other than following the doctor's and therapist's advice to the letter, is to try and keep your mental state in check. By far the hardest part for me was trying not to be depressed. I practically defined my identity by mountain biking and rock climbing and to have that taken away was tough.

    Try and keep your focus on the future. Even if your finger doesn't get any better (though I truly hope it does), you WILL be able to do ALL the activities you love again. Even rock climbing can be done with 9 fingers, Tommy Caldwell is one of the best climbers in the world and lost his index finger years ago. Here is is free climbing el cap: .

    In the meantime, run and hike and keep your endorphin withdrawal at bay.

  44. #94
    S21
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    Hi Justin and everyone else!!

    It's been good to hear all the stories on here - especially Justin - its been really insightful and good to hear from someone who's had a similar experience.

    I lacerated my FDP tendon in right middle finger (dominant hand), back in January this year with a piece of glass - lucky not to injure my FDS!! I had two failed primary repairs (both ruptured however waited 4 weeks after the first rupture due to my physic not detecting the rupture which was extremely frustrating making the second attempt less likely to work well as the tendon had retracted).

    I have now been through the two stage Hunter process and am 11 weeks post second stage. Like everyone else its been a difficult process and has been hard to stay upbeat and motivated but have tried my best. I am a huge tennis player as well climbing and other sports and for tennis it is vital I get a good range of motion/flexion at the dip joint to hold the racket properly.

    I saw my doctor and physic yesterday and despite them thinking I have a good gliding tendon (as when i isolate the movement of the dip when putting pressure on the middle joint when my hand is straight - i get good flexion). However when my hand goes into fist position, I am only getting around a 20 degree flexion at the dip joint which is not sufficient when holding small objects or a tennis racket.

    My surgeon now believes it is a tendon length issue/ tendon being too loose and says my only option would be to tighten it if I wanted more flexion at the dip in a fist position.

    This is good/bad news for me as after 4 surgeries and 8 months since initial injury, the idea of another op is a killer, and also feel I should be careful going into this finger again after the amount its been through already - I wouldn't want to make things worse.

    I also have slight contractures at the dip joint and an even more slight at the pip.

    Anyway wanted to ask you if you've heard about tightening the tendon when its too loose ( I also don't want to worsen the contractors). My doctor says its actually the best of the problems to have, as I have a free gliding tendon which doesn't seem to be scarred up so tightening it should have less risks than the whole two stage procedure I've been through but I am def gonna try and get some second opinions before operating again.

    Anyway any advice would be amazing and I am hear if anyone needs advice on the process as I have been through it!!!

  45. #95
    S21
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    Finger tendon graft surgery, off the bike for a while-photo-11.jpgFinger tendon graft surgery, off the bike for a while-photo-10.jpgFinger tendon graft surgery, off the bike for a while-photo-6.jpg

  46. #96
    S21
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    I attached a few pics above, I am getting only 20 degrees flexion at the dip joint when in a fist and 30 degrees when my fingers are semi flexed as in the last photo.

    From what I've read considering i only tore my fop and therefore only lost motion in my DIP joint, that these results are mediocre.

    Thanks for your help!

  47. #97
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    Quote Originally Posted by S21 View Post
    Hi Justin and everyone else!!

    It's been good to hear all the stories on here - especially Justin - its been really insightful and good to hear from someone who's had a similar experience.

    ....

    Anyway wanted to ask you if you've heard about tightening the tendon when its too loose ( I also don't want to worsen the contractors). My doctor says its actually the best of the problems to have, as I have a free gliding tendon which doesn't seem to be scarred up so tightening it should have less risks than the whole two stage procedure I've been through but I am def gonna try and get some second opinions before operating again.

    Anyway any advice would be amazing and I am hear if anyone needs advice on the process as I have been through it!!!
    Hey S21,

    Sorry to hear about what you are going through. I know exactly how you feel, especially in regard to the undetected rupture and the effect that has on your final prognosis. You are pretty darn lucky to still have the FDS intact (and the pulleys I assume).

    I have read about shortening and lengthening procedures and my totally uneducated opinion is that it is much better to have to shorten a tendon than lengthen one. I would think to shorten the tendon they just cut it down at the muscle end and re-attach it the same way the did the initial repair. Hopefully that would only involve opening your wrist up and not messing with the finger. If it did involve going into the finger I would be more hesitant. Contractures suck and is one of the more annoying issues I live with now post-op.

    Definitely get another opinion and also find out if you need to act soon or if you can wait awhile and see if things get better. I know that ~1.3 years out from my last surgery, my hand has gained a lot more range and strength.

    I'm riding my MTB more than I ever have and you will get your life back too! Go read some of the other posts in this forum to put things in perspective.

    Stay strong!

  48. #98
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    Thanks for the reply Justin

    Out of interest what did your doctor/ physic tell you to do regarding your contractures - did they continue to improve post 3 months after stage 2? I am simply doing stretching exercises where i put the joints back - my physio hasn't given me anything else but would be good to seek a second opinion.

    Thanks!!

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    Quote Originally Posted by S21 View Post
    Thanks for the reply Justin

    Out of interest what did your doctor/ physic tell you to do regarding your contractures - did they continue to improve post 3 months after stage 2? I am simply doing stretching exercises where i put the joints back - my physio hasn't given me anything else but would be good to seek a second opinion.

    Thanks!!
    They were very conservative with stretching my finger because of the previous failures. I had a brace to wear 24/7 that kept the finger bent for the first three months or so. Then I ended up getting one that slightly straightened the finger. I used that for over a year, but I would say the contracture stayed about the same as it was at month 3. Never really had any exercises to do. Like I said, they were very paranoid about another rupture.

    These days I stretch my finger/hand every day. With some stretching it loosens up, but it doesn't stay that way.

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    ... and if we just ...

    " Thanks Justin and everyone for initiating this thread, it helped me through out the surgeries to keep myself motivated"



    Hi guys, my name is sai.. I am a software developer..i had a cut on my tendon(left hand index finger) on feb 17th .. i went through a two phase surgery(hunter rod technique).

    My doctor is Jason k Haslam(Nashville).. He is a great doctor

    /*I thought to give brief updates for every two weeks(hope it will be helpful to someone)*/


    First surgery was performed on March 17th. A silicone rod is kept in my finger. Exactly after two weeks the stitches came out.

    Below are the pics after the removal of stitches on march 31st.
    There is lot of pain for first two weeks and i was taking pain killers.
    I took 12 pain killers for first two weeks(i thought these pain killers might create side affects so i thought to handle the pain myself)
    Finger tendon graft surgery, off the bike for a while-img_2688.jpgFinger tendon graft surgery, off the bike for a while-img_2690.jpg

    I am not able to move my fingers for two weeks. Slowly i got my motion back after two months(may 17th)...

    Doctor suggestion
    Stop overdoing the OT(just repeat the exercises 5-6 times a day)
    Massage everyday gently
    No physical activity with the "left finger" and no heavy activity with the "left hand".

    I was performing physical therapy myself. My doctor suggested me some exercises(your doctor might recommend a therapist after 1st stage). My finger remained tight for 20 days after the removal of stitches.
    This is how my fingers look April 1st 2016
    Finger tendon graft surgery, off the bike for a while-img_2695.jpg




    On april 9th 2016
    my finger still got some swelling and it is tight.
    Finger tendon graft surgery, off the bike for a while-img_2726.jpg
    Finger tendon graft surgery, off the bike for a while-img_2727.jpg

    --------------------------------------------------------------------
    On May1st this is how my finger looks(below picture)... there is no swelling and got 90% of my flexion back....

    Finger tendon graft surgery, off the bike for a while-img_2809.jpg

    -----------------------------------------------------
    On may15th this is how it looks with full flexion...
    I started using my left hand for typing(but not the left finger).. I started to learn typing without index finger...
    I started typing fastly and accuratley by using my three fingers..
    my pinky finger for 6 buttons on key board(q,a,z,w,s,x) ...
    my ring finger for three buttons (e,d,c)....
    my middle finger for 6 buttons (r,f,v,t,g,b)...
    I dont know how i am gonna adjust back to my original style of typing after the full recovery...

    Finger tendon graft surgery, off the bike for a while-img_2863.jpg



    I had my second stage on june 20th(exactly after 3 months)
    This is how my hand looks on the same day after surgery.
    There is no pain this time... i didn't take single pain killer(weird)...
    Finger tendon graft surgery, off the bike for a while-img_3041.jpg

    Stitches come out after 3 days or one week
    This is how my hand looks on july 18th
    Started hand therapy(this time i was suggested to use therapist)
    Only passive motions till my button is removed.


    I can make a fist(with the help of other hand), but i cannot extend all my fingers... There is no swelling but tendon is tight.. so are all the fingers..
    Finger tendon graft surgery, off the bike for a while-img_3140.jpg
    -----------------------------------------------------
    A button is used to hold my tendon(below picture)
    the button comes off after 6 weeks from surgery

    Finger tendon graft surgery, off the bike for a while-img_3141.jpg

    -----------------------------------------------------------------
    wrist is kept bent at a certain angle using the split...
    The split below is a custom splint
    Finger tendon graft surgery, off the bike for a while-img_3142.jpg

    This is the angle i was talking about.. the hand will be in this position for 3 months....
    Finger tendon graft surgery, off the bike for a while-img_3143.jpg


    --------------------------------------------------------
    I am scheduled to visit the therapist two times a week.
    In the below picture the palmers Cocoa butter formula cream is used to soften the skin and remove scars upto some extent and massage the scars two times a day(only after the wound closes or heals up),,, and the silicone strips(brown colored strips in pic) are used to break the scars... I was suggested to stick these silicone strips to the scars when i sleep at night ...
    Finger tendon graft surgery, off the bike for a while-img_3144.jpg



    Yesterday(26thJuly), my button is removed. My finger feels tight. I have good active motion in my other fingers.
    Last edited by sai12367; 07-27-2016 at 09:44 AM.

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