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finger/thumb Finger joint replacement

Discussion in 'Other Joints Forum' started by PrincessDi, Apr 9, 2017.

  1. PrincessDi

    PrincessDi new member
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    9 months ago I severely broke my index finger. Due to the continuous pain and lack of movement I have decided to have a PIP joint replacement.

    Does anyone out there have experience of this procedure? I'm keen to hear about the first few weeks post-operatively.

    I'm a secretary and wondering how long I will be in a hand splint and in too much discomfort to type.

    Thanks in advance.


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  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    @PrincessDi Welcome to BoneSmart! Hand surgery is certainly a specialty to its own. I am sure our members will chime in with their input soon.
     
  3. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Not personal experience but I've had plenty of professional experience with them.

    For instance, other readers may not know that a PIP joint stands for Proximal Inter Phalangeal joint. Which is this one indicated here

    finger_arthroplasty_anat02.jpg

    The joint is replaced using silastic implant like this

    finger silastic-horz.jpg

    As for recovery, the finger might be small but it's very sensitive to trauma of surgery. It's also very nerve rich so could be quite painful. Therefore you will need to be very stringent with your pain medication and elevation. Keep your hand very high while it's painful. You will probably find it hard to keep it elevated at night when you are in bed. Perhaps, if you have soft headboard, you could use a safety pin to pin it by the bandages to the headboard so it doesn't end up at mattress level!

    As for rehab, you surgeon would most likely make it 2-4 weeks before you start doing that but, contrary to advice given elsewhere on this forum, good activity and compliance with exercising is essential to get back good functionality.

    Let me know if you need anything more.
     
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  4. PrincessDi

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    Thanks Josephine - that is very helpful. So returning to work in a week or so is probably not going to happen then.

    I look forward to hearing from others who have had the surgery.


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  5. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Definitely not! It's a 6-8 week process, I'm afraid.

    And we don't have any other members with finger joint replacements yet.
    This "Other Joints" section is relatively new.
     
  6. PrincessDi

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    I have my surgery date - 23 May. I'm guessing there is still no one on here who has had their finger joint replaced?


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  7. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    I think you are our pioneer in the finger joint area - leading the way.

    So glad you got your date and it's not a long wait. We will be here for you!
     
  8. PrincessDi

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    Oh lucky me . I will report back after surgery on the recovery process and results.


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  9. suse

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    Hi @PrincessDi ,
    I read with interest your post.
    I. Was wondering how your surgery went. I hope it worked out ok and you are now fully recovered.
    I have a date in June for two PIP replacements on right hand due to osteoarthritis. The joints aren’t too bad at the moment but have been getting worse very quickly over last two years and I don’t want to leave it till it’s too late and fusion would be only option. I need mobility.
    I’ve found it very hard to find anyone who has had this done who could reassure me, then I found your post. I would really appreciate your experience especially regarding your expectation and whether the surgery met that especially regarding function and mobility of the joint.
    I have time to change my mind I guess but if I do I won’t get the chance again.
    Many thanks
     
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  10. MrLee

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    I recently had PIP joint arthroplasty for osteoarthritis. Before the surgery, the pain would occur randomly, hurt for some time and eventually recede. It got worse and after taking shots in the joint for a year, I decided to have the surgery based on my surgeon's advice and promises that I would not have any more problems.

    So now after 12 weeks I must say I am very disappointed. At least I know when it is going to hurt, that is, whenever I use it. The range of motion is about a half an inch. Almost 3 months of therapy and no improvement at all. I am scheduled to see the doctor again soon, he said if it is not improved by then (which I am sure it won't be) he will do another procedure to loosen it up enough so I can use it. Oh joy.

    It's not over, but as of now I would go back to where I was before. At least I could use the finger. If this continues I would just as soon cut it off at the joint so it doesn't get in the way or hurt so much when I try to use it. I can only hope revision surgery is wildly successful.
     
  11. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    12 weeks is awfully early to start getting disappointed. Fingers can take a lot longer than that to rehab. Maybe even as long as 6 months. Nothing happens quickly in hands!

    And FWIW, I've never known any subsequent procedures done to 'loosen up' finger surgeries. And I've worked with some premier hand surgeons in my time.
     
  12. krazz

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    @PrincessDi I saw that no one else has had this surgery in here.

    I destroyed my PIP joint in 2014. They first tried to save my joint with a couple of pins drilled through each side holding the joint in place. That was the worst pain keeping those in for 6 months the pins slowly damaged my other joint. The pins did not fix it and I was stuck in the 'hook'" position. I decided to have the surgery Dec 2015. Right after the surgery it felt so much better because the pins were out. I went to work after a couple of days.

    I didn't have to type too much so I was lucky. After 2 weeks of rest they took out the stitches and the Dr had me try to slightly move my finger and I was able to. I went through about 2 months of rehab and could bend it to 95 degrees which I was very happy about. I was told the pain would eventually go away but 4 years later it hasn't. I have to slowly warm up and stretch the joint out every morning. If I bump into anything or it's closed too fast there is instant sharp shooting pain. If I move it slowly there is slow dull pain.

    If you have this surgery most likely you will have pain when moving it.
     
  13. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    You mean the swan-necked' deformity!

    swan necked deformity.JPG

    Actually you had an unfortunate experience there and one that few people experience. Normally they heal very well but they do take a long to do so.
     
  14. MrLee

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    By "loosen up" my finger I am referring to improved range of motion. After 3 months of rehab and exercises, my ROM for the joint replaced is about 20 degrees. That is almost no improvement from the date I started the rehab. Also the angle of declination of the finger is almost 40 degrees. My doctor stated on my last visit about 3 weeks ago that he can work on it some more and improve it considerably. I have no idea what he means. But I see him again this month, I hope he is correct. I would love to see some results of other patients who have had this surgery, but I have found very little information in that regard, so I only have my doctor's word on it.
     
  15. krazz

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    @Josephine
    I mean hook position the swan is for DIP I had the PIP blown up and stuck. The surgeon called it a blown trigger that they call a hook because it looks like a hook and gave me the arrggg matey..

    trigger-finger.jpg

    Why me??? :)
     
    Last edited: Aug 1, 2018
  16. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Oh, well release of the trigger should resolve that issue. Since there is nothing wrong with the actual joint then you don't need an arthropasty.
     
  17. krazz

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    @Josephine
    I had it :)
     
  18. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    But did it resolve your issue is what I meant (and forgot to ask!)
     
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  19. krazz

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    @Josephine

    Kinda resolved it. I can move it up to 95 degrees if it's really warmed up and slowly stretched. If I bump into anything or it's closed too fast there is instant sharp shooting pain. If I move it slowly there is a slow dull pain. It's been 4 years. The only thing I can think of is the surgeon decided not to cement it into the bone and it's pulling a very very tiny bit out and that's the pain.
     
  20. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    Is it a Silastic implant?
     

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