Hand /wrist recovery
This information is targeted at patients in the immediate recovery period after surgery. It covers general instructions until the first follow-up visit usually in the first 2 weeks. The information here is general and not specific to individual operations which have there own specific protocols found on this website or from your surgeon at Queenstown joint clinic.
Splints and slings
plaster slabs
Often after hand surgery you will be placed in a backslab. This is a half plaster called a backslab. The incomplete cast allows for swelling after surgery and the bandaging keeps it on.
It is important to keep your backslab dry and leave it on. If it gets wet it will soften and not protect your surgery.
The slab also acts as a dressing to protect the wound. It transpires and absorbs fluid to keep the wound from getting wet which increases infection.
It will usually be changed when you attend your first follow-up visit with Dr Phoon after surgery.
Please ask any therapists to check your post-op plan from Dr Phoon before taking away your backslab.
Slings
for hand and wrist surgery your are often given sling after surgery. In most instances this is only to rest the limb and prevent swelling.
Remaining in the sling all the time will create elbow stiffness so most patients are allowed to remove the sling when they are not moving about.
It's important to elevate the hand/wrist slightly to improve venous drainage. When in bed this may be on pillows. Else the arm of a chair, or a table is also sufficient.
Walking about without the sling early on will tend to create swelling in the hand as the blood pools.
Full casts
If it is necessary to immobilise the hand or wrist for a longer time after surgery a full plaster may be required. This will be applied after the wound has healed, at the 1-2 week mark after surgery.
Full plasters may be synthetic 'fibreglass' or plaster. A waterproof cast has a synthetic lining that can shed water. Otherwise a cotton or synthetic wool lining may be more comfortable but not waterproof.
Plaster casts are use when careful molding is required to protect your surgery.
Ask your therapist about care and exercises for your cast.
Splints and braces
Often specific or custom made splints may be provided. These will often be fitted by your therapist after surgery.
It is important to still follow any surgical restrictions you have been given. Often early in the recovery period you will need to keep the splint on at all times.
Ask your surgeon if it is safe to remove your splint for washing initially. As your body heals you will be able to remove the splint for supervised therapy.
Towards the end of your treatment you may only need the splint for comfort.
When you are moving into the strengthening and stretching phase of your recovery wearing your splint too much will slow your body's return to normal function.
Wound care
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Leave your surgical dressings intact until your follow-up wound check at 7-14 days post-op. Keep your wound dressings clean and dry. Sometimes you may be given a cloth over-dressing or bandage that may be removed after 2 days; the waterproof under-dressing must be left intact.
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The wound underneath is clean and sterile from operating theatre as long as the dressing is intact. If the seal is broken, and especially if the dressing has become wet from bathing – get it redressed by the clinic nurse or your local doctor. Do not wash the wound or bath in seawater – this will increase infection risk.
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Some swelling and bruising is common after surgery. Redness and warmth that extends past the edge of the dressing may be a sign of infection and a doctor should be consulted. Please contact Dr Phoon’s office if this is a concern.
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In most cases stitches will need to be trimmed or remove at 7-14 days post-op. The wound should be kept dry for at least 2 days after this. Larger wounds on the forearm may have dis-solvable sutures.
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You should not swim until the wound is completely clean and dry. This is usually not before 3 weeks.
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Exercise and physiotherapy
This is determined on a case-by-case basis. The ability to exercise depends on the strength of your surgical repair/implants/sutures as well as the extent and condition of your injury.
None-the-less, all patients in slings should still perform elbow and shoulder exercises as well as neck stretches. to prevent these adjacent joints becoming stiff and deconditioned.
Most cast and splints require attention to avoid unintended stiffess. You will normally be given light finger exercises to be performed regularly in the initial weeks.
A specific program will be tailored to your needs, if you are unsure please contact Dr Phoon.
contact your surgeon urgently if you have any of the following:
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You have increasing pain, swelling or redness.It is normal to have pain and swelling after most surgery especially in the first 2 days.
This should normally be constantly improving and can be treated with rest, ice and elevation.
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You temperatures (>38.0ºC), chills, fevers or night sweats.
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Ongoing drainage of fluid or blood from your wound after 48 hours.
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Chest pain, shortness of breath.
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Other unexpected injury or symptoms.
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your cast is lost by accident