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Having surgery is a major consideration, and you should think about it seriously. Keep in mind, at the same time, that while surgery may be rather strange and unusual to you, it is actually very common in our practice.
The decision to have surgery on your hand is a team effort. It should be explained clearly to you, and you need to have a good understanding about what we are talking about. We both need to consider all the options, and then together come to a reasonable conclusion that surgery is better for you than not having surgery. In the end, the decision to have surgery is up to you, because only you know how much your hand problem is interfering with your quality of life. I will discuss with you any other complications which might be peculiar to your particular surgery.
It is important to understand that significant complications are rare. If you have any questions, please, write them down and bring them into the office for your next appointment. If you have questions after we have decided to perform surgery, either call me or write them down and bring them with you to surgery. I will talk with you prior to surgery, to answer any last minute questions.
Here are some things to think about:
Almost all surgeries have the risks of:
Infection. Although rare, any cut in the skin, may predispose you to an infection. Most infections can be successfully treated with oral antibiotics (by mouth), but rarely intravenous (IV) antibiotics or even additional procedures may be needed.
Injury to local structures like nerves, blood vessels, or tendons. This complication is very rare as well, but may rarely occur.
Failure to completely cure the problem. This would relate to things like getting all of a mass out, removing all the Dupuytren’s tissue, completely put the fracture back into place, etc. Patients with severe carpal tunnel syndrome may have persistent problems as there may be permanent nerve damage. The goal of surgery may at times be to make things better or prevent them from getting worse, not to make things “normal.” Realistic expectations are important.
Recurrence. This is similar to the above problem of not completely curing a problem. Certain conditions such as carpal tunnel syndrome or ganglion cysts have realistic, documented recurrence rates even with the best of surgery.
Rare problems like reflex sympathetic dystrophy (RSD) or Complex regional pain syndrome (CRPS). This is a chronic pain condition that is believed to be the result of dysfunction in the central or peripheral nervous systems. The condition is characterized by pain, swelling and stiffness in the affected hand or extremity. The pain may be out of proportion to the injury that triggered it.
Anesthesia complications are rare. You should meet with your anesthesiologist on the day of surgery and discuss anesthetic options with him/her. If you have any concerns regarding your anesthetic (such as a history of nausea/vomiting or other complications from an anesthetic) you must inform your doctor and the anesthesiologist.
Scar. This is not really a complication, but rather a normal process following surgery. Most scars on the hand and wrist heal quite nicely without significant cosmetic issues. Some people have a tendency to form more or thicker scar than others. Occasionally scars may be tender, but this usually resolves with time and scar massage.
* Modified from Dr. David Nelson, MD