Recovery: Ligament Tear Surgery and Wrist Synovitis Management

Triangular Fibrocartilage Complex (TFCC) Tear Surgery and Wrist Synovitis

Dear Director: I underwent ligament and cartilage injury repair surgery on October 29, 2021.
Two weeks after the surgery, the physician recommended that I wear a splint for an additional month before starting rehabilitation.
He mentioned that wearing the splint would be beneficial for the healing of the injured area, totaling six weeks of splint use.
However, other rehabilitation specialists have differing opinions and believe that it is not appropriate to wear it continuously.
I feel quite confused.
What is the recommended method for applying heat therapy—should I use an electric heating pad or hot water? Thank you for your clarification.

Hsu Li-mei, 50~59 year old female. Ask Date: 2021/11/15

Dr. Wang Zhaomin reply Rehabilitation

After hand surgery, it is generally recommended to immobilize the hand for four weeks to facilitate tissue healing.
However, individual conditions vary, and the duration of immobilization may differ based on the surgical method or procedure.
It is essential to discuss the appropriate treatment plan with both the operating surgeon and the rehabilitation physician.
Since hand joints are not flat surfaces, soaking in warm water can achieve better contact and facilitate heat transfer.
If there are wounds or if soaking is inconvenient, an electric heating pad can also provide effective heat therapy.
Online consultations cannot replace an in-person examination; please visit a healthcare provider for an accurate diagnosis and to arrange appropriate treatment.

Reply Date: 2021/11/15

More Info

After undergoing ligament and cartilage repair surgery on October 29, it is understandable to have questions regarding recovery, especially concerning the use of a splint and the management of wrist synovitis. The recovery process can vary significantly depending on the specific nature of the injury, the surgical technique used, and individual healing responses.

Recovery Timeline and Splint Use
Your surgeon's recommendation to wear a splint for an additional month after the stitches are removed is quite common in orthopedic recovery protocols. The purpose of the splint is to immobilize the affected area, allowing the ligaments and cartilage to heal properly without undue stress. This immobilization is crucial, especially in the early stages of recovery, as it helps to prevent re-injury and promotes optimal healing conditions.

On the other hand, the differing opinions from rehabilitation specialists regarding the prolonged use of a splint may stem from a focus on functional recovery. While immobilization is essential initially, excessive splinting can lead to stiffness and reduced range of motion. Therefore, a balance must be struck between protection and mobility. It is advisable to follow your surgeon's guidance closely, as they have the most comprehensive understanding of your specific case. If you feel uncertain, consider seeking a second opinion or discussing your concerns directly with your surgeon.

Heat Therapy for Recovery
Regarding the application of heat therapy, both electric heating pads and warm water can be effective, but they serve slightly different purposes. Electric heating pads provide consistent warmth and can be adjusted to your comfort level, making them convenient for prolonged use. However, it is essential to monitor the temperature to avoid burns, especially if you have reduced sensation in the area due to surgery.

Warm water, on the other hand, can be soothing and is often used in hydrotherapy settings. Soaking the wrist in warm water can help relax muscles and improve circulation, which may aid in reducing stiffness. However, ensure that the water temperature is comfortable and not too hot.

Managing Synovitis
In terms of managing wrist synovitis, which is inflammation of the synovial membrane surrounding the joint, it is crucial to follow a comprehensive approach. This may include:
1. Rest and Protection: Continuing to protect the wrist from excessive strain during the healing process is vital.

2. Ice Therapy: While heat can be beneficial, ice therapy can also play a role, especially if there is swelling. Applying ice packs for 15-20 minutes several times a day can help reduce inflammation.

3. Gentle Range of Motion Exercises: Once your doctor approves, gentle stretching and range of motion exercises can help maintain flexibility and prevent stiffness.

4. Physical Therapy: Engaging in physical therapy can be beneficial for guided rehabilitation, focusing on strengthening the wrist and improving function.

5. Medication: Over-the-counter anti-inflammatory medications may help manage pain and swelling, but always consult your physician before starting any medication.

Conclusion
In summary, the recovery process following ligament and cartilage repair surgery requires careful management of immobilization and rehabilitation. While your surgeon's advice to wear a splint for an extended period is aimed at ensuring proper healing, it is essential to balance this with the need for mobility to prevent stiffness. Heat therapy can be beneficial, whether through electric pads or warm water, but should be used judiciously. Always consult your healthcare providers regarding any concerns or uncertainties, and ensure that your rehabilitation plan is tailored to your specific needs. Wishing you a smooth recovery!

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