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.
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!
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:
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.
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!
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!
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