Our Summary

This research paper is about a survey done on hand and wrist surgeons in Australia to understand the post-surgery recovery process for a specific wrist injury. When the Triangular Fibrocartilage Complex (TFCC) in your wrist gets injured, it can sometimes lead to surgery. After the surgery, patients typically need to undergo rehabilitation to regain the function of their wrist and hand. However, there isn’t a universally accepted method for this recovery process.

The survey asked the surgeons about their recommendations for how long the wrist and forearm should be immobilized, when patients should start moving their wrist and forearm again, and if they had any experience with the injury happening again after surgery.

The results showed that the surgeons’ advice varied a lot. Some didn’t think immobilization was necessary while others recommended it for up to 8 weeks. Most of them suggested a period of 4 to 6 weeks for both immobilization and the start of movement exercises.

The most commonly recommended support device was a ‘sugar-tong’. Also, about 37% of the surgeons reported that they had seen cases where the injury happened again after the surgery.

The study concludes that more research is needed to understand how these rehabilitation decisions can impact the recovery of patients.

FAQs

  1. What is the recommended postoperative rehabilitation protocol following TFCC foveal repair surgery?
  2. What is the most recommended orthosis following TFCC foveal repair surgery?
  3. Does the timing of postoperative rehabilitation influence patient outcomes after TFCC foveal repair surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hand surgery is to follow the recommended postoperative rehabilitation protocol closely to ensure optimal healing and recovery. This may include wearing a prescribed orthosis, starting range of motion exercises at the appropriate time, and attending follow-up appointments for monitoring progress. By following the advice of your healthcare provider, you can improve your chances of a successful outcome after hand surgery.

Suitable For

Patients who may be recommended hand surgery include those with injuries to the Triangular Fibrocartilage Complex (TFCC), which is a structure in the wrist that helps stabilize the distal radioulnar joint. Surgery may be necessary to restore stability in these cases. Other patients who may be recommended hand surgery include those with conditions such as carpal tunnel syndrome, trigger finger, arthritis, tendon injuries, nerve compressions, and fractures in the hand or wrist. Each patient’s specific condition and individual circumstances will determine whether hand surgery is recommended for them.

Timeline

Before hand surgery:

  1. Patient experiences pain, limited range of motion, and instability in the wrist and hand.
  2. Patient undergoes consultation with a hand and wrist surgeon to discuss the need for surgery.
  3. Pre-operative tests and evaluations are done to determine the extent of the injury and the need for surgery.
  4. Surgery is scheduled and the patient undergoes the procedure.

After hand surgery:

  1. Patient is prescribed postoperative rehabilitation to restore wrist and hand function.
  2. Immobilisation of the wrist and forearm may be recommended for a period ranging from immediately to 8 weeks.
  3. Range of motion exercises may be started anywhere from immediately to later than 8 weeks post-surgery.
  4. The most recommended orthosis for post-surgery immobilisation is a ‘sugar-tong’.
  5. Some patients may experience post-surgery re-rupture, with 37% of surgeons reporting such cases.
  6. Additional clinical research is recommended to evaluate the impact of postoperative rehabilitation on patient outcomes.

What to Ask Your Doctor

  1. How long will I need to wear a splint or cast after the surgery?
  2. When can I start range of motion exercises for my wrist and forearm?
  3. What type of orthosis or brace do you recommend for post-surgery support?
  4. What activities should I avoid during the initial recovery period?
  5. How long will it take for me to regain full function and strength in my hand and wrist?
  6. Are there any specific exercises or therapies that you recommend for rehabilitation?
  7. What are the potential risks or complications associated with this surgery?
  8. How often will I need to follow up with you for postoperative care?
  9. What signs or symptoms should I watch out for that may indicate a problem with the surgery or my recovery?
  10. Can you provide me with any resources or information to help me better understand and prepare for the surgery and recovery process?

Reference

Authors: McCarron L, Coombes BK, Bindra R, Bisset L. Journal: J Hand Surg Asian Pac Vol. 2024 Aug;29(4):302-308. doi: 10.1142/S2424835524500309. Epub 2024 Jul 12. PMID: 39005178