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Aftercare & Restrictions

Aftercare: What do I need to do?

What to expect after the procedure

Restrictions: Do's & Don'ts After the Procedure


WHAT IS THE AFTERCARE AFTER NEEDLE APONEUROTOMY?

 

Bandages & Dressings


At the end of the procedure, your hand needle sites will be covered with small adhesive bandages (Band-Aid®) and possibly a small gauze bandage. You will need to keep your bandages dry immediately following the procedure, but you will be able to remove the bandages that evening and wash your hand normally that evening unless otherwise instructed.

Usually, all bandaids are taken off and left off the day of the procedure. Wet bandaids should be removed immediately and replaced with new bandages the day of the procedure. Sometimes the skin will crack like a paper cut in the palm and will weep for a few days like a scraped knee. If your skin cracks, you will need extra bandaids until the area dries up.

Ice & Elevation

These are the key to a pain free recovery. A reusable icepack will be applied to your hand immediately following the procedure. You should keep your hand pointing up as much as possible and ice your palm frequently the day of and the day after the procedure.  You will be given instructions on the use of a night elevation pillow for your hand.

Splinting

Use of a night brace or splint may be recommended if you have several fingers involved or significant joint contracture. If this is recommended it is usually used for eight to twelve weeks to help further straighten the fingers. The splint is usually fabricated by a hand therapist either locally or in your home town. In some cases, it may be possible to use a prefabricated splint as well.

Therapy

Regular hand therapy is usually not required after Needle Aponeurotomy.  If you will need to wear a splint, you are usually referred to a hand therapist for fabrication of the splint.

 




WHAT TO EXPECT AFTER NEEDLE APONEUROTOMY

Numbness in Your Fingers

Your fingers may be numb for several hours after the procedure, and you may have tingling in the fingers for the next few days. This is related to the local medication injected for pain control and from stretching the fingers that have been bent for so long.

 
Soreness in Your Palm and Fingers

Mild soreness of your palm and fingers may last a day or two after the procedure.  If there is significant PIP work done, your soreness may last longer.  Use of elevation and ice will help significantly with your discomfort.

Variable Need for Pain Medication

For most patients, narcotic pain medication is rarely needed after the procedure.  Following the recommendations for rest, ice, and elevation of the hand during the first two days after the procedure results in very little post-procedure discomfort.  Use of regular or extra-strenght Tylenol®, Advil, or Aleve for the first few days after the procedure usually resolves any residual discomfort.  Narcotic pain medicines will be prescribed for the release of severe contractures involving several digits.

Swelling in the Palm and Fingers


Normally you will have very little swelling if you rest, ice, and elevate your hand as instructed.  Some patients are more prone to swelling, and in this instance it usually lasts less than a week.

 



RESTRICTIONS


You should be able to proceed with normal light activities (eating, dressing, bathroom and driving) on the day of the procedure. Plan to avoid activities which involve a strong grip for one to two weeks after the procedure - to avoid unnecessary discomfort.

 

PERSONAL CARE

Dressing

You can use your hand to dress the same day of the procedure.  If you have to pull on tight boots or socks, have someone assist you with this. 

Showering

You can shower the day of your procedure.  After your shower, remove your bandgaes.

Eating

You can use your hand to eat the day of the procedure.

Toileting

You can use your hand for basic toieting.  Make sure you keep your hand clean.  If you get your bandages wet when washing your hands, please clean and dry the needle site areas and apply new bandages.

 

TRAVEL

 

Staying in Town


Based on studies done at several institutions, there is no need for you to stay in town after the procedure. However, if you are having the procedure on both hands, you will need to be in town for two days, as we can only treat one hand per day.

Flying

You can fly the same day as your procedure. You should not use your hand to carry or pull your luggage.

Follow Up visits

Based on studies done at several institutions, regular follow up visits are not necessary for uncomplicated Needle Aponeurotomy (Percutaneous Release).  Complications are extremely rare.  If you are from out-of-town, you will need to have a primary medical doctor available to contact (in your home town) in case any problems arise.  Dr. Grabow can then discuss any issues with your doctor.

WORK

Lifting and Carrying

For seven days, you are to avoid gripping things against the skin where the needles were used. This means that you should only grip or lift with your fingertips for the first week after Needle Aponeurotomy.

Work Restrictions or Disability

Work restrictions are based on the type of work you perform.

  • Sedentary or keyboarding – two to four days.
  • Clerical work requiring extensive filing or carrying – 7 days
  • Heavy labor – 7 days
  • Disability forms – Dr.Grabow will sign short-term disability forms for 7 days.
  • If you are a local patient and it is determined that you need more time off of work, we will make arrangements for you.
  • If you are from out of town and believe you will need more time off, a local physician will need to sign your forms.


TRANSPORTATION

Flying

You can fly the same day as your procedure. You should not use your hand to carry or pull your luggage.

Operating a Plane

Due to the shearing stress on your hands, if you are a pilot, you should wait at least 7 days before returning to work.

Driving a Car

Most patients are able to drive immediately after NA. If you are concerned that you won't be able to drive, you should make alternate arrangements for two days after the procedure.

Riding a Motorcycle

Due to the shearing force on your hands when operating a motor bike, you should wait at least 7 days before operating a motorcycle or dirtbike.



RECREATION

Sports

In order to avoid hand inflammation, you should wait at least seven days before resuming golf, tennis, weight training or strenuous use of the hand.

Swimming, Hot Tubs, and Baths

You can wash your hand the day of the procedure, but you should not go swimming or submerge your hand under water for at least two days after the procedure.

Gambling

You’re in Vegas, so if you like to gamble, you are not restricted from doing so. Ideally, you should rest, ice, and elevate your hand as much as possible the day of the procedure. We recommend you relax, sight-see, and go to a show the day of your procedure. The day afterwards you can gamble if you choose, but you should still try to elevate your hand as much as possible and hold a cold drink to reduce inflammation.   

Please follow the following recommendations for specific gaming scenarios.

Card games

Use your non procedure hand for holding cards. You may use your procedure hand to manipulate single cards or chips but otherwise you should rest your elbow on the table with your hand elevated upwards.

Craps

Due to the amount of hands touching the dice, only use your non procedure hand to throw the dice. You may use your procedure hand to place single chips, but use your non-procedure hand to pick up stacks of chips.

Chips

Chips are dirty, so they should not be touching your wounds.  In general you should use your non-procedure hand for most chip handling. You can pick up or place individual chips with the fingertips of your procedure hand but you should not palm or hold a stack of chips in your hand as many craps or roulette players like to do.
Horseback Riding

Since we want you to avoid shearing forces (forceful rubbing) over the palm of your hand for a week after the procedure, I would advise against horseback riding for at least 10 days. Although I do understand you can ride without gripping with the involved hand, there is more force to your hand than you appreciate. Additionally, we want to reduce the risk of infection: your horse, saddle, reins, and riding gloves all have bacteria on them naturally.  Eventhough the needle holes are small, bacteria is smaller and can get in if given the opportunity early after the procedure.
   

Last updated 1.2.09

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