Post-Surgery Finger Joint Swelling: Rehabilitation and Home Care Tips

Postoperative swelling of the finger joints?

Hello: I just underwent a tendon transfer surgery (transferring a tendon from my leg to my arm).
Due to wearing a brace for 1.5 months post-surgery, my finger joints have not been active.
After removing the brace, my ring and little fingers are noticeably swollen.
Since I previously had damage to my brachial plexus, I cannot perceive pain clearly; occasionally, I notice that the swollen areas feel warmer than the other fingers when touched.
I would like to inquire if this condition can improve through rehabilitation.
Is it advisable to apply ice or heat at home?

Wen, 20~29 year old female. Ask Date: 2021/12/01

Dr. Shi Guozheng reply Orthopedics

It is important to actively engage in rehabilitation, which may include both ice and heat therapy.

Reply Date: 2021/12/01

More Info

Post-surgery rehabilitation, particularly after a tendon transfer or similar procedures, is crucial for restoring function and reducing complications such as swelling and stiffness. In your case, it sounds like you've experienced significant immobilization due to the protective brace, which can lead to joint stiffness and swelling in the fingers, especially if they haven't been moved for an extended period.

Understanding Swelling and Rehabilitation
Swelling in the fingers after surgery is a common occurrence, especially when the joints have been immobilized. The lack of movement can lead to fluid accumulation, which manifests as swelling. Additionally, if there has been nerve damage, as you mentioned, it can complicate the sensation and perception of pain, making it harder to gauge the extent of the swelling or discomfort.

Rehabilitation Strategies
1. Early Mobilization: Once your doctor has cleared you to remove the brace, it’s essential to start gentle movements. Begin with passive range-of-motion exercises, where you or someone else moves your fingers gently to help maintain flexibility. Gradually progress to active movements as tolerated.

2. Therapeutic Exercises: Incorporate specific exercises designed to strengthen the fingers and improve range of motion. Simple exercises include:
- Finger flexion and extension: Curl your fingers into a fist and then open them wide.

- Finger abduction and adduction: Spread your fingers apart and then bring them back together.

- Tapping each finger to your thumb can also help improve dexterity.

3. Use of Heat and Cold Therapy: Ice packs can be beneficial in the initial stages post-brace removal to reduce swelling and numb pain. Apply ice for 15-20 minutes several times a day. After the swelling has decreased, heat therapy can be introduced to promote blood flow and relax the muscles. A warm towel or heating pad can be used for this purpose.

4. Compression and Elevation: Wearing a compression glove or wrap can help manage swelling. Additionally, keeping your hand elevated above heart level can assist in reducing edema.

5. Gradual Return to Activities: As you progress, gradually reintroduce daily activities that involve hand use. Start with simple tasks and increase complexity as your strength and range of motion improve.

Home Care Tips
- Self-Massage: Gently massaging the swollen areas can help improve circulation and reduce swelling. Use a lotion or oil to facilitate smooth movements.

- Hydration and Nutrition: Staying well-hydrated and maintaining a balanced diet rich in anti-inflammatory foods (like fruits, vegetables, and omega-3 fatty acids) can support healing.

- Monitoring Symptoms: Keep an eye on the swelling and any changes in sensation. If the swelling does not improve or worsens, or if you experience increased pain, it’s essential to consult your healthcare provider.

When to Seek Professional Help
If you notice persistent swelling, significant pain, or changes in color or temperature in your fingers, it’s crucial to reach out to your healthcare provider. They may recommend physical therapy or further evaluation to ensure that there are no complications, such as nerve entrapment or vascular issues.

In summary, rehabilitation after tendon transfer surgery is a gradual process that requires patience and consistency. By incorporating gentle exercises, utilizing heat and cold therapy, and maintaining proper care, you can significantly improve your finger function and reduce swelling over time. Always consult with your healthcare provider before starting any new rehabilitation program to ensure it aligns with your specific needs and recovery goals.

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