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  • TFCC tear ulnar shortening and carpal tunnel release

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    Old 11-12-2014, 06:09 AM   #1
    Tink6810
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    TFCC tear ulnar shortening and carpal tunnel release

    Hello, First let me say that I only recently stumbled upon these boards and I so appreciate being able read the experiences of others dealing with similar issues. Thank you for sharing your stories!

    That has made me decide that I would share mine as well. I have had bilateral carpal tunnel for 21 years. I've been wearing braces off/on throughout the time to help ease the symptoms. Then just over 2 years ago I started having debilitating ulnar sided wrist pain that would inhibit my ability to function. The pain would start ulnar sided, then grow to include mid hand/wrist and travel up my ulna to the elbow. I work at a seasonal restaurant and have to do a lot of heavy lifting, I also work out including lifting weights, push ups etc. This all had to stop as I could not even turn a door knob when the pain came.

    I would wear my braces, apply ice and take ibuprofen. Within a few days, I would be able to return to near normal activity. But as I would be active, this cycle would just repeat. It grew to become more frequent. My right dominant hand) became worse than the left.

    At the end of this past work season (end of September) I decided to see the doctor about this. Turns out that I significant tears in the TFCC, damage to the lunate and ulna head from bumping as well as significant carpal tunnel on the right. I have a TFCC tear with mild impaction and moderate carpal tunnel on the left.

    So I have moved forward with the course of action to repair the right TFCC with ulnar shortening and release of the carpal tunnel all in one surgery.

    I am 2 weeks post-op at this point.

    I had general anesthesia and a nerve block for the surgery. I highly recommend the nerve block. It helps get you through those first 10-12 hours post op! But start you pain meds before the block wears off. This surgery is painful, but is manageable. I do not like to take meds. So I was anxious to get off the Rx painkillers as quickly as possible. I did so on the 5th day post op. I have been taking ibuprofen since then. With one exception which I will explain.

    I was in a long cast post op. At 2 weeks they removed that cast, removed stitches from 6 of the 7 incisions, (the long incision on ulnar side of arm has melt away stitches), took xrays and fitted me to a removable cast. That was a painful day. This is the only time I've taken a Rx painkiller again. It helped along with ice and keeping arm elevated, to get the pain managed once again.

    I did keep arm elevated and iced several days post op and that really helped with pain/swelling. Believe it or not, if you put enough ice on, you can eventually feel it through cast. It also helps to apply the ice to your fingers and upper arm.

    At 2 weeks post op, I am still on full restrictions, but have some finger movement exercises to do to help stretch tendons. These movements are painful. I do them after I've taken ibuprofen, and apply ice afterward.

    The ulna bone has not started to heal. This could take a while (i'm not quite a senior citizen, but I'm no spring chicken). Next up is another visit to surgeon in another 2 weeks (4 weeks post op) for more xrays. Hopefully at that time I will begin PT (without weight). Expected PT duration is 3+ months. Expected return to heavy lifting is 5 months. We'll see as I progress if any of this gets adjusted.

    OK a few things to think about if you are facing this surgery:
    • Premake meals and freeze them ahead of time in containers you can open with one hand
    • Recruit a designated driver as you won't be able to drive
    • Don't plan on signing things if you're surgery is on dominant hand. Write out checks for bills ahead of time, or use online banking to pay bills
    • Cut the one sleeve off some old sweatshirts if it's cold weather so you have something to wear that keeps your good arm warmth
    • Women, get a sports bra that you can put on/remove with one hand - no hooks!
    • Plan to wear pull-on pants, sweats, yoga pants etc.
    • Purchase shampoo & conditioner in pump bottles. It's much easier to dispense from those with one hand in the shower
    • Get some umbrella bags to cover your cast in the shower. Secure them at the top around your arm with a rubber band. The hospital where I had my surgery had them in the lobby, they let me take them free of charge to use for this.
    • In cold weather use a sock to protect you casted hand, a glove/mitten won't fit.
    • Have a small tote bag with handles that you can sling over your good arm for carrying things
    • Keep easy to open, healthy snacks available. Since you are not going to be as active, you won't eat as much. You may want light snacks. Tuna in pouches, peanut butter crackers are sweet but still have protein, etc
    • Drink lots of water
    • Be sure to take something to combat the constipation caused by the painkillers. Miralax in water will help plus you'll be drinking water!

    This was a lot of typing with my non dominant hand! I'll try to keep updating. Hope this is helpful to others!

     
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    Old 11-14-2014, 11:18 AM   #2
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    Re: TFCC tear ulnar shortening and carpal tunnel release

    Since having the long arm cast removed on 11/10 (4 days ago) I have had increased pain and discomfort. A few times my arm has swollen so much that the removable molded splint/cast has become tight. I've used ice, ibuprofen and raising my hand up to help. Honestly I mainly keep my arm elevated most of the day.

    Some things that concern me:
    1. I've been doing the finger movement (tendon gliding) exercises, but my middle finger is now painful at the middle knuckle. There is pain and tightness from mid palm to the fingertip, but really bad pain at the middle knuckle. Is this normal? Anyone else experience this? Perhaps anyone that has had carpal tunnel release?

    2. The last 1-2 inches of my ulna near the elbow is very sore. It feels like the bone is bruised. It hurts to rest it on the arm of a chair, or even to touch it. Any one who has had ulna repaired/shortened have this issue?

    Any and all help is greatly appreciated!

    Last edited by Tink6810; 11-14-2014 at 11:22 AM.

     
    Old 11-14-2014, 06:43 PM   #3
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    Re: TFCC tear ulnar shortening and carpal tunnel release

    I can't answer your 2 questions, but can speak on the cast change.

    I only had a short arm cast, but I found the transition from my initial plaster splint/cast to the fiberglass one made things more painful again. I ended up needing painkillers again for a few days. Also, after 2 weeks in the fiberglass cast (4 weeks after surgery), I found that a lot of swelling had gone down so much more that I was flopping around in the cast. I ended up needing to go in to have it replaced. It was a couple more weeks after that when I was fitted with an Exos moldable/removable cast. I liked that much better.
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    Old 11-15-2014, 04:42 AM   #4
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    Re: TFCC tear ulnar shortening and carpal tunnel release

    Thanks for that input. Your posts have been so informative. Thank you for sharing

     
    Old 11-24-2014, 06:21 AM   #5
    Tink6810
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    Re: TFCC tear ulnar shortening and carpal tunnel release

    Somethings are improving, some things seem worse. But that's only because I'm starting to do more things. Some of then tendon gliding exercises are getting less difficult to do!!

    I am still in the very thick rigid molded to my arm splint.

    But making a full fist or straight fist remain painful. ANY movement to the side is extremely painful, feels equal to or worse than the actual ligament tear pain prior to the surgery. I can not rotate the wrist/arm. I don't have much grip, very little strength. I'm trying to use my fingers for small things, like folding laundry, but I can't do it on anything heavier than a t-shirt, even with the help of my other arm, I just can't hold the weight.

    I've been trying to type on then keyboard using both hands. For the main alpha keys it's not so bad, but to try to reach the other keys or anything that needs a tilt of the wrist is painful. And this is with the splint on.

    The majority of the severe pain is from the wrist and area where the ligaments/TFCC were repaired. Occasionally I attempt to pull/push some thing with a small bit of weight to it and I feel stress/pain at the site where the ulna was cut.

    Resting the arm on the ulna side is painful. It feels like the plate is poking through the skin. Just running the fingers of my other hand along the ulna incision I feel like sharp shocks as I pass over the plate area. At times, just sitting and not even using the arm, it feels like the skin or tissues inside are snagging on the plate. If this is something that continues, I can understand why people have the plate removed later.

    I may be over doing it. By later in the day, my hand/arm is swollen and aching. I end up needing to ice it and elevate it.

    Heading back to the doctor for my 4 week follow up. Will see what comes next!

     
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