Post-surgery driving instructions
After Surgery Instructions - DeQuervain's Release
If this condition does not resolve by splinting or injection, surgery may be indicated. This surgery is done as an outpatient procedure, either under local anesthesia or with a regional block done by an anesthesiologist. The surgery consists of releasing the roof of the tendon tunnel, removing friction between the tendons and the tunnel. After surgery, you will be sent home in a padded dressing with a splint for the wrist and thumb included in the dressing.
- The dressing applied in the operating room should be left on during this week, and is not changed until you return for the first post-surgical appointment in the office. The dressing should be kept clean and dry. For showering, plastic bags can be used to cover the dressing and keep it dry.
- Ice can be applied over the surgical area to help reduce swelling and pain. The ice should be kept in a plastic bag or similar container so that the dressing remains dry. Ice is applied as needed, usually only during the first 2 or 3 days after surgery.
- It is important to keep the operated hand and wrist elevated during the first 2 or 3 days after surgery, This means keeping the wrist between the ceiling and the your heart, no matter what position you are in. We do not like to use slings, and it is better to keep your elbow and shoulder moving. For sleeping, the arm can be placed on a pillow over the chest, or out to the side on pillows, or you can roll on the non-operated side and place it on pillows in front of you.
- Finger motion is good to do on an intermittent basis, trying to stretch the fingers and then bend them as much as the dressing allows. Light activity with the operated hand during this week is encouraged, and it is good to use it for things such as lifting books or plates. Heavy physical exercise should be avoided, so that the dressing does not rub over the sutures, and so that sweat does not occur around the surgical site.
- A local anesthetic, or numbing medicine, will be used for the surgery or at the end, so that there will be minimal or no pain for the trip home. This medicine usually lasts 8 hours, but has been known to last much longer in some cases, even up to 3 days. Pain medicine will be prescribed at the hospital, and can be used if needed after surgery. Many patients do not need any pain medications, or can get by with Tylenol or Advil. If the prescription medicine is used, you should not drive, operate machinery, or use alcohol afterwards.
- If you have any problems or questions after surgery, please call the office. Whenever possible, call during normal business hours.
- At the first post-surgical appointment in the office, your dressing will be changed. Sutures are usually left in one more week. A splint will be needed, and if you have a splint which includes your thumb ("thumb spica splint"), bring that with you to this appointment. If you do not, we will arrange for one. The splint is worn full time this week, except for showering.
- The dressing should be removed before showering, and it is acceptable for the sutures to be wet from soap and water running over them. The area can then be dried, and can even be cleaned with alcohol or peroxide before applying the new dressing if desired. Dressings can be gauze pads with tape, or band aids, depending on your preference. The operative area should not be submerged under water, such as in dishwater or bathtubs.
- As stated above, the splint is worn except for showering during this week. Activities can be moderately increased during this week, including lifting as tolerated.
- At the second post-surgical appointment, the sutures are removed. Showering is still okay without covering the area, but it should not be soaked for 3 days. After 3 days, when the suture holes are closed, it is okay to soak the area such as in bath water. Also after 3 days, a dressing or band aid is not needed.
- Lotion massage into the surgical scar should be started 3 days after the sutures come out. Any type of hand lotion can be used, and the massage is done twice a day for 3 to 5 minutes each time.
- The thumb splint can now be worn on a gradually decreasing basis over the next 4 to 5 weeks. Naturally, the splint should be removed first for light activities. Activities such as driving, sleeping, and typing can be done without the splint as you feel comfortable. If there are periods where the wrist feels painful or more swollen, then the splint should be worn until this resolves.
- Exercises to regain wrist and thumb motion can be done, gently, several times a day starting this third week. Supervised therapy is normally not needed following this surgery. Strengthening can also be started with a soft ball or stress ball, progressing to heavier strengthening as swelling and pain allow.