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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.

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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

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