Post-Surgery Pain and Swelling: Complications After Finger Injury

Two years post-surgery, the healing site still experiences pain and swelling?

Hello Doctor, in 2020, I had an accident that resulted in a rupture of the flexor tendon in my ring finger.
After suturing, although the wound healed after a few months, there is a translucent protrusion with a black dot in the middle.
Upon returning for a follow-up, I was informed that it was an adverse reaction and was advised to coexist with it (due to concerns that surgery might affect the sutured tendon).
Now, two years post-surgery, the area still experiences intermittent pain, and the translucent swollen part (which feels like it has fluid inside) often peels.
Recently, when I peeled off the dead skin, I discovered a small hole in the middle, and when pressed, tissue fluid (sometimes white liquid) would come out.
After a period of swelling and pain at the healing site of the ring finger, it returned to its original state (I suspect inflammation).
I would like to ask the doctor: 1.
Which specialty should I consult for this situation? 2.
Would surgically removing the larger suture remnants improve the condition? 3.
Can doctors at other hospitals access the past surgical photos? (I would like to try consulting different physicians)...
I am currently very anxious.

Dou Dou, 20~29 year old female. Ask Date: 2022/09/08

Dr. Shi Guozheng reply Orthopedics

1.
Hand surgery
2.
May improve
3.
May not be visible

Reply Date: 2022/09/08

More Info

After experiencing a finger injury that required surgical intervention, it is not uncommon to encounter ongoing pain and swelling, even months or years after the initial injury. Your situation, particularly with the translucent bump and the presence of fluid, suggests that there may be complications related to the healing process. Here’s a comprehensive overview of your concerns and recommendations based on medical knowledge.

1. Understanding Post-Surgical Complications: The symptoms you describe, including pain, swelling, and the presence of a translucent bump with fluid, could indicate several issues. These might include scar tissue formation, a possible infection, or a seroma (a pocket of clear fluid that can develop after surgery). The black dot you mentioned could be a sign of necrosis or a foreign body reaction, which can occur if the body reacts to the materials used during surgery.
2. Recommended Specialists: Given your symptoms, it would be advisable to consult with a hand surgeon or an orthopedic specialist who focuses on upper extremity injuries. They can assess the condition of your finger, evaluate the integrity of the tendon, and determine if there are any underlying issues that need to be addressed. If there is a concern about the skin or soft tissue, a plastic surgeon with experience in hand reconstruction might also be beneficial.

3. Surgical Intervention Considerations: Regarding the removal of larger suture remnants, this could potentially improve your symptoms, especially if the sutures are causing irritation or if they are contributing to the formation of scar tissue. However, this decision should be made in consultation with your surgeon, who can evaluate the risks and benefits based on your specific situation.

4. Accessing Medical Records: When seeking a second opinion, it is essential to have access to your previous medical records, including surgical notes and imaging studies. Most hospitals maintain a system where you can request copies of your medical records. You can ask your current healthcare provider for assistance in obtaining these documents, which can then be shared with the new physician for a comprehensive evaluation.

5. Managing Pain and Inflammation: In the meantime, managing your pain and inflammation is crucial. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help alleviate discomfort. Additionally, applying ice to the affected area may reduce swelling. However, it is essential to avoid excessive pressure or manipulation of the area, as this could exacerbate the symptoms.

6. Physical Therapy: Engaging in physical therapy may also be beneficial. A physical therapist can provide exercises to improve mobility and strength in your finger while also addressing any scar tissue that may have formed. They can tailor a rehabilitation program specific to your needs, which may help alleviate some of the discomfort you are experiencing.

7. Monitoring Symptoms: Keep a close watch on your symptoms. If you notice any signs of infection (such as increased redness, warmth, or discharge), or if the pain worsens, it is crucial to seek medical attention promptly.
In conclusion, while it is understandable to feel anxious about your ongoing symptoms, there are steps you can take to address your concerns. Consulting with a specialist, considering further surgical options, and engaging in physical therapy can all contribute to improving your condition. Remember to communicate openly with your healthcare providers about your symptoms and concerns, as this will help them provide the best possible care for your situation.

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