Finger/Thumb Thumb Trapezium Replacement 6/16/17

[kayak59]

Really kicking myself over this thumb incision situation right now and wondering just how much I caused this. In all fairness, some I think but based on my experience with all my previous surgeries, and the amount of pain I had around this incision, I think the fluid was building up from day one and given the pointy shape of the bone... it was only that part of the incision that never healed like the upper part did. But, lesson for others perhaps. The incision did cover a sharper shape than anywhere else I've ever had done plus people have told me of incisions that never fully closed on relatively flat areas!

I am now being REALLY good and wearing (by choice) a full wrist brace that absolutely will not let the thumb or wrist bend at all. I am keeping the wound totally dry, but contrary to the doctor's instructions, I am using a bandaid to partially close the incision. He just put gauze over it but the incision kept hurting and I saw it was stretching and trying to open the healed section. The bandaid does not close it all the way and I've had no pain since I did that. Resigning myself to staying inside for the rest of the summer until the skin seals as even sweat soaks the site. Will be seeing the doctor again on the 18th and I am hoping that no more surgical intervention is required.

On the job front, got two interviews this week so even if I get the work from home one, I'll be too tired to do much -- and even more so if I get the on site one. Still limping but no where near as bad as before and continuing those glute specific exercises. Wish my luck everyone please!

 

[Lynnallison175]

@kayak59. I was told a long time ago, we only get one chance to heal properly. I believe that. I also know that while our bodies are miraculous things, they are not perfect. It is not your fault your thumb incision split open, unless you were doing thumb gymnastics with it (not!) **** happens. All you can do is remember recovery is a marathon, not a sprint. My first knee recovery was almost textbook and I was back to work in three months. The second one was crazy, I got a fracture blister and went back to work after five months. Fluid builds up in response to trauma, when there is no more room for it in the joint, is has to come out some way. Your was a split incision, mine was a fracture blister.

All will be well. Stop kicking yourself. I'm wishing you no infection and no more surgical intervention. Happy healing.

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[kayak59]

Thanks @Lynnallison175 !

 

[Coppernob]

@kayak59 sorry to hear about your incision problems. Perhaps there is something to be said for being in a cast after all. I had mine changed yesterday, but have to wear
one for another 4 weeks. It's so frustrating at times, but there's no way I can overwork the thumb. I hope yours improves really quickly and that you don't need further surgery. Linda x

 

[kayak59]

Thanks @Coppernob Linda. Unfortunately the incision still isn't showing any signs of healing but it is healthy and not showing any sign of infection so that is good. Not sure what the doctor will say on Tuesday but I am going to ask him if I should perhaps see a plastic surgeon. Maybe there is some kind of artificial skin that can be used to cover this. I feel like the longer it is open, the more likely it is to become infected. Those cold spring fed Ozark Mountain rivers are calling me and my kayak but I know I can't risk that kind of exposure. Other than the incision, the thumb feels good. I am not supposed to move it of course (because of the incision) but there is no pain. The other half of the incision is completely healed. Very frustrating!

 

[kayak59]

Sigh...... Back to the hand surgeon and left with stitches in the incision. Wasn't worse but no better either. Expected this and wish he'd done it during the last visit. He started the stitches about 1/2 from the incision on either side and just brought the skin together. They'll stay in for about 3 weeks. Oh well. "It is what it is". (I wish I knew where that saying came from.) Don't really want to go outside in 100 degree temps anyway.

Still waiting to hear back about the jobs......

 

[Lynnallison175]

@kayak59. Sorry for the new stitches, but glad the incision has been closed up. Keep it clean and dry and rest it as much as you can. Glad for the update. My thumb has been achy and painful all day.

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[sistersinhim]

What a life journey you have been through. Your experience should certainly be able to help many people. I pray that this last stitch up heals your wound.

 

[kayak59]

I am so ruddy frustrated! The wound is not healed yet, stitches barely keeping it together, tendon exposed and sticking to every dressing. It will be six weeks on Friday.

Did some research and this could take weeks more if not months to heal. I have to find some way to protect this from infection but still let me use the hand. Other than the skin not healing, the thumb feels fine. Some nerve tingles but no pain.

I think I'd be using it 100% -- albeit with a brace for paddling and other such activities if not for this.

@Josephine any advice other than be patient? Will be seeing the hand surgeon next week. Am seeing my hip specialist tomorrow and will ask him what he does for situations like this.

 

[Josephine]

Gee - what does your surgeon say about it?
And how about a photo?

 

[kayak59]

The hand surgeon did not give me a Plan C for this. The info I read said exposed tendon took s lot longer to granulate so I may not have too many options. Part of the problem I feel is that the wound continuously weeps and then the fluid sticks to the bandage - although the tendon does too.

I have it loosely covered now and will see what my hip specialist says. It's not infected and it doesn't hurt but I am supposed to keep my thumb stuck out like I am hitching a ride and I don't think that is making any difference. I know patience is probably the only option but wondered what they do in the UK for situations like this. It's a small incision and probably wouldn't be a issue if not for where it is.

P.S. The stitches were originally black! I think the fluid changed the color somehow!



Thanks Josephine


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[Josephine]

It's not infected - the wound continuously weeps and then the fluid sticks to the bandage

It looks infected to me! And the other comment would, in my opinion, confirm it.

It's a small incision and probably wouldn't be a issue if not for where it is.

You might think that but it's a BIG incision for the hand!

wondered what they do in the UK for situations like this

These things are not dictated by a country or locality.

When was the last time your hand surgeon saw this? If it is longer than a week or two then he needs to see it double quick. Asking a hip surgeon's opinion of it is rather like asking a hairdresser's opinion on your feet! It's not his speciality.

And what is that yellow stuff in the wound? Is it packing or tissue?

 

[kayak59]

Thanks again, @Josephine

The yellow stuff is the tendon. I have very bony hands and there is no fat or anything between the skin and the tendon. The weeping has been happening since about week one and the hand surgeon knows about it -- told him when he took the stitches out and when he restitched it. He feels this is all due to the cortisone injection which was just about in the middle of the problem area.

This looks pretty much like it did when the surgeon restitched it -- actually, it was gaping much wider. There basically hasn't been any change in weeks now so I am not worried about it, just frustrated and annoyed. My surgeon is out of the country and I think if I tried to call now, they'd just send me to an Urgent Care. My Mum (Retired English nurse) saw this last night and she would have said something if she thought it infected. I would think an incision is an incision regardless of what part of the body its on and it certainly wouldn't hurt to have him look at it.

Again, thank you for responding so quickly! Stress and anxiety about the job situation is getting worse and I so want to get out on the water in my kayak but I know better than to do that with an open wound like this.

 

[Josephine]

He feels this is all due to the cortisone injection which was just about in the middle of the problem area.

hmm... maybe, maybe not. But you have psoriatic arthritis as well. Are you on oral steroids? Because that could have a profound effect on healing. But not the intra-articular shot as that cortisone is synthetic and reputedly doesn't have that kind of side effect.

I think you should ask to be referred to a plastic surgeon so he can maybe do a skin graft as I think that's probably the only answer now. It may not be infected now but if it's left like that much longer, there is a very grave risk that it will become so.

 

[kayak59]

thanks Josephine! My Mum said the same thing about the skin graft. I will see my hand surgeon on Monday and will ask about that.

 

[swmrgirl]

Hi @kayak59 -- I've been catching up on your thread. Sorry you're having trouble with the incision. Have you seen the surgeon yet?