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Tendon reattachment post-surgery question
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Tendon reattachment post-surgery question

2744251?1207475465
Hi Doc,

First of all, I want to say this is a rather long story and I hope you read it. My name is Nick(26yrs) and I severed a tendon on Nov. 26, 2007 after punching through a glass window in my door. It was very bad to say the least. Right after I did this I thought that I cut an artery because so much blood was coming out. Also, I couldn't lift my hand up with my wrist. It was just hanging there but I could move my fingers. I thought I had cut a tendon but since I could move my fingers I wasn't sure. You must know that I am living in the country of Ukraine right now and when this happened. It was about 1am when this happened so the ambulance came and picked me up and took me to the emergency room. The doctor said I didn't cut a tendon and stitched me up. That night the pain was excruciating to say the least and I had no pain killers. The doctor gave me some but they didn't work in killing the pain. The next day I visited a doctor at the local hospital to get follow-up. The doctor was about 32 years old and he assured me that I had not cut a tendon. He said in two weeks we would take out the stitches. So I waited like a good boy and after two weeks he took out the stitches. After he took out the stitches and the bandage I could see a small bump on the opposite side of my wrist to where the initial cut was. I pushed on it and it hurt very much and I could hear something like crunching inside so the next day I went to the doctor and told him about it. He did another X-Ray and there was a piece of glass lodged in my wrist. It was about an inch long. So he cut open my wrist and removed it. Now I thought after him removing it my wrist would feel much better and start to heal. After one week I still couldn't bend it right and had no power. So I started investigating the internet and comparing my bad hand to my good hand and I saw a major difference. I noticed when I made a fist or exerted force a tendon popped up in my good hand and it didn't in my cut hand and I could also feel an obvious difference. If you make a fist and follow an imaginary line between your index and middle finger down to your wrist you will see the tendon pop up. It is a very strong tendon. I am describing my dorsal wrist so you know. It was very obvious to me but I thought it might be partially cut so I went to the doctor and told him this and he said that yes I could be right! WOW! What a horrible doctor. The same doctor who said I didn't cut a tendon 3 weeks ago and never even recommended getting some test to make sure. I pretty much diagnosed myself the whole time. After this he referred me to a "specialist" hospital here in the city of Dnepropetrovsk. SO I went there with my wife one day and met with a doctor. He sat me down at his desk and asked me to flex my fingers and etc. I could do everything so he said there is no tendon damage and that it's all in my head!! Honestly he said that but in Russian of course to my wife! I was done with Ukrainian doctors at this point. I just walked out and decided I would have to leave the country to get decent help so I took a train to the Czech Republic where I saw a doctor who told me that it could be partially cut and that an MRI would show if it was cut or not. Now you must know that I recommended the MRI and he said it would be expensive. I found out it cost like $900 bucks! Again he was rather young and didn't seem too knowledgeable. I couldn't pay that so I decided to come back to Ukraine and search more. I kind of gave up in Prague because it has become like the USA in their approach to medicine. Insurance based. Bad. Ukraine is still more social but it's bad because there doctors are some of the lowest paid in the world and they know what doctors make in the western world. I am not saying they are bad doctors because of this but it does have an effect. So I came back to Ukraine and it is now 2 months after the incident and I am getting worried because I know tendons need to be repaired very soon after they are cut or it's bad. So my wife asked her friends in Kiev if they could recommend a good orthopedic hospital and they did so we were off to Kiev. We met there with a doctor who first of all said to get an ultrasound which cost $30. I got the ultrasound and it revealed exactly what I feared...a torn tendon. Now I still don't exactly which tendon it is. I think it's the extensor longus or radial carpi..I don't know but I know you know. :-) So anyway I made an appointment to have the surgery. The surgery was done on Feb. 18, 2008 and the incident occured on Nov. 26, 2007 so about 3 months had passed. The total cost for hospital stay and medicine was $1,000. I paid a lot more than Ukrainian citizens but I earn an American salary and the average Ukrainian salary is about $250 a month so for me that price was great especially since I didn't have health insurance. I don't know what I would have done if this happened in the USA. It would have been bad for me I know. The doctor who did the surgery studied in Austria and is considered to be one of the best in Ukraine when it comes to the hand/wrist area. There are not many hand specialists in Ukraine as you can imagine many of them move overseas to make more money. So I had the surgery on Feb 18 and I had to wear a gypsum splint for 1 month and it came off on 17March. When the splint came off my wrist was stiff as a board. I went to see the doctor at that time and he said that I need to massage the area everyday to break up scar tissue and adhesions and to soak my hand in hot water. Also he prescribed electro therapy. Today is April 6th and I can bend my wrist a little more but it is still very stiff. I can bend it up much more than I can bend it down if you understand what I mean. In other words I can lift my fingers above my wrist but not below them very well. The doctor is in Kiev and I live in a city that is 8 hours away by train so that is why I don't go to him everyday if you are wondering. I am supposed to go and see him on April 20 and he will do some serious work with the hand therapist there and give me some more directions. Also he said not to lift very heavy things and not to use the hand very forcefully because the tendon is still reattaching itself. I think I put that right. The doctor took many great photos of the inside of my wrist and forearm. It shows the ruptured tendon along with his work and the completed job. I would love to send them to you and see what you think and also your advice on my situation. I attached one photo but it doesn't show the finished job. I would like to send the other photos also. I know it takes many months before I will be anything close to normal but want to know another doctor's opinion in the USA. I will be returning to the USA on June 1st and may need to visit a specialist for further therapy. Also, I have been taking Glucosamine/Chondroitin supplements everyday. Please respond to me. Thank you for your time.

Sincerely,
Nicholas
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2 Comments Post a Comment
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424839_tn?1268189846
ok you have a nextesor tendon laceration and your six weeks post op today the surgeon is right on the money with his treatment and therapy you won't be lifting heavy stuff until week 12 post op there is a direct protocal that we as Hand therapist have to follow during therapy. Tendons take along time to heal since they do not have there own supply of blood. it sounds like the doctor knows what he is saying. the tendon you ruptured sounds like extensor carpi radialus. Doing the scar massgae will really help with vreaking up the scar tissue when you do it the figer/s that you are using there finger nail should blanch due to the preasure being applyed. if you have anymore question you can PM me

Mdeic1
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472190_tn?1207476171
Thank you very much for your prompt reply. I really appreciate as I know how valuable your time is. It really makes me feel good to have a second opinion agree with what was said to me already. Thank you for reading my post but can you elaborate a little more on what you mean by, "Doing the scar massgae will really help with vreaking up the scar tissue when you do it the figer/s that you are using there finger nail should blanch due to the preasure being applyed. if you have anymore question you can PM me"

What exactly do you mean by "when you do it the finger/s that you are using there finger nail should BLANCH? due to the pressure being applied.??"

And also I am doing self-massage with my other hand. Correct?

Thanks,
Nick
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424839_tn?1268189846
your fingernail should turn almost white that means your applying enough preasure to move the skin and the scar tissue what is happening is the scar tissue forms it graps ahold of anything around it tendons shkin muscle that is why you might see a pinching of the scar when you extend your wrist doing the scar massage will help break up the scar tissue so that the tendons glide proberly. also if you use vitamen E on the scar it will help decrease the aperance of the scar. yes you are doing it so that you can judge the pain from the massage doing the massage also helps with any hypersensasion caused by he surgery
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472190_tn?1207476171
How often should I massage? The more the better? 10 minutes and then stop? As long as I can until my other hand gets tired? And is it normal that at about 7 weeks postop my wrist can hardly bend? And the massaging is the MOST important aspect in the rehabilatation process, right? Actually, I can bend my wrist up a lot more than down.  After researching I read that the extensor carpi radialus is the main tendon used to abduct the hand. The main power transfer tendon. Am I correct?

If I understood the doctor correctly he had to take another tendon and attach it since the ends of this one had moved too far apart to reattach. He also said that I should be about 98% the same after lots of rehab. Would you say the same? I have never had such an injury and I must be more patient. It gets frustrating, you know? I just want to know that my wrist is where it should be in the recovery process and not too worry.

Also, are you a doctor and if so where do have a practice? I will be in Dallas soon and maybe I could see you.
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424839_tn?1268189846
I am a hand therapist I am an Occupational therapist I just do the Rehab for injuries just like yours and yes you are right were you should be at 7 weeks.  massage it for 5 min 6-10 times daily also doing your exercises sohuld be the same 5 times daily. if he had to do a tendon transfer you'll be at about 90 percent but do you know what tendon he took? with the motion one comes easier than the other and yes that is the main tendon that radial devates your wrist. so you are doing good just be patient and it will come together and you are doing fine wish my patients were as determand as you are. you are going to be the one that they try and slow down so not to hurt your self do your exercises and the massage and you will be fine
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472190_tn?1207476171
The doctor didn't really prescribe any exercises. He just said to massage it and soak it hot water. Should I try and bend more than is comfortable. Force it? What exercises do you mean? I am not sure which tendon he took but you think 90% is the best I will recover? I guess that's good but I know with work and patience anything is possible. I really appreciate your words of wisdom. I haven't been massaging it 6-10 times for 5 min daily though. I need to massage more.  But the stiffness at 7 weeks postop is totally normal, yea? Are you in the USA and if so where in the USA are you? When I return maybe I could come see you however I have no insurance. I was thinking of getting insurance when I return to see a rehab specialist like yourself but since this injury occurred before the insurance start would it be considered a pre-existing condition and therefore insurance would not pay for the rehab?
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Avatar_n_tn
it has been 5 wks since i had a tendon from my ring finger pulled up from my wrist area up to my pinkie.i can't move it on my own yet is that normal. i have had three of my fingers amputated down to no knuckle and part of my pinkie to second knuckle of my left hand which is my dominate hand.
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Avatar_m_tn
Next time don't punch through glass and you'll save all of us the torture of having to read this.
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Avatar_f_tn
Real nice.  Here Nicholas is trying to get the best advice he can find and you can't help yourself from being a *********!!  Don't read it if it's too long or tedious for you.  I have to wonder why you're on this site to begin with..  I also have suffered two severed tendons on my left thumb and found Nicholas' questions to be right on track with my own and found usarmymedic1's concern and thoughtful instructions to be of great help to me as well.  Your lack of empathy leads me to assume that you've never had a similar accident or made any mistakes.  It's my experience that the universe will see to it that you learn missing lessons on empathy, compassion, and the cost of being a class 1 a@#hole all in good time.  And when you see the tremendous amount of self centered narcissistic s^%$heads such as you when you need guidance, it will be then that you reflect on Nicholas and the callous way you treated him.  Good luck!
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Avatar_f_tn
Real nice.  Here Nicholas is trying to get the best advice he can find and you can't help yourself from being a *********!!  Don't read it if it's too long or tedious for you.  I have to wonder why you're on this site to begin with..  I also have suffered two severed tendons on my left thumb and found Nicholas' questions to be right on track with my own and found usarmymedic1's concern and thoughtful instructions to be of great help to me as well.  Your lack of empathy leads me to assume that you've never had a similar accident or made any mistakes.  It's my experience that the universe will see to it that you learn missing lessons on empathy, compassion, and the cost of being a class 1 a@#hole all in good time.  And when you see the tremendous amount of self centered narcissistic s^%$heads such as you when you need guidance, it will be then that you reflect on Nicholas and the callous way you treated him.  Good luck!
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Avatar_f_tn
Hello,
I was reading your story.
In am a sculptress and just severed my thumb tendon,,I was carrying a vase of flowers to my neighbor who had spine surgery and tripped on a lawn ornament. I fell right on the vase, with glass cutting into both arms everywhere. But that was not the worse.
The glass cut right trough to to bone where the joint bends.

The hospital emergency had no one to stitch back up the tendon do I can not bend it in half.This is traumatic for me.
How much can I expect to spend to hopefully get it fixed in Austin, Texas where I live ...or is there somewhere else I can go?
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