Enter #:

What's This?

Dupuytren's Clinic Product Recommendations Patient Education Patient Education Patient Education Patient Education
Surgery

   Surgery
Things to Consider

I have created this section for my patients who may be in need of surgical treatment. While I do emphasize nonoperative measures before considering surgery, sometimes surgery is necessary. If you are not one of my current patients you are welcome to review this page for your own education. However, the remainder of this section is password protected so that I may share more detailed information with my patients who are considering surgery that I cannot share with the general public. If you are currently one of my patients and need an access code to this section please contact my office via phone or email. 

Sincerely,

Ryan J. Grabow, MD

 


TOPICS IN THIS SECTION

Common Questions

Preparing for Surgery

Anesthesia & Pain Control

After Surgery - How to Prepare, What to Expect

Preventing Complications

 


Having surgery is a serious consideration.  Keep in mind, that while surgery may be rather strange and unusual to you, it is actually very common in my practice. While you are reading this page, remember Shakespeare's admonition to "know yourself," and take into consideration your own natural "worry level". Are you the type who never worries about anything, or are you a championship worrier even when things are expected to go well?

The decision to have surgery is a team effort. I need to explain it 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 problem is interfering with your enjoyment of life, and how willing you are to accept an unknown future. I want to help you make that decision.



Here are some things to think about:

Do you understand what I have been talking about? I try very hard to talk in plain English and to make sure you understand what is going on at each visit. I have written an extensive website to empower you with information. You should not have surgery if you don't know what we have been talking about. If you have questions, please, write them down and bring them with you to your next visit or to the operating room.

Do you feel that you have tried all the appropriate non-operative possibilities? In some cases, like an infection or an open fracture, there may not be any reasonable alternatives besides surgery, but most of the time there are non-operative alternatives that are reasonable. You should not have surgery until you understand and have considered the non-operative possibilities and decided that they are not a reasonable option for you. Discuss this with me if you are unsure.

Have you considered the possibilities if you do NOT have surgery? I will try to tell you what you can expect if you do not have surgery. Sometimes, the problems of NOT having surgery are close to zero (for example, living with your arthritis for a bit more), but sometimes they are serious: not having a cat bite abscess cleaned out, for instance, may cause the loss of function of part of your hand or even death.  Discuss with me the possibilities that might happen if you do NOT have surgery.

Do you understand the expected, possible, as well as the unlikely outcomes of your particular surgery? Unrealistic expectations will make both you and me unhappy. For instance, the pain of arthritis in your hand will not be cured by surgery for carpal tunnel. Know exactly what your diagnosis is, what the surgery is intended to treat, and what results you can expect. For example, arthritis surgery is generally designed to DECREASE your pain, NOT ELIMINATE IT, and a fracture fixation is designed to IMPROVE YOUR BONE POSITION and INCREASE YOUR CHANCES FOR GOOD FUNCTION, it is not designed to MAKE YOUR HAND, WRIST, ELBOW, OR SHOULDER NORMAL (that is, run the clock back in time to before you had your fracture). Understand the expected, possible, and unlikely outcomes of your particular surgery. If you are not sure, write down your questions and ask me for more information.

Do you understand the likely, the possible, and the rare complications of your particular surgery?

Almost all surgeries have the risks of:

a) infection
b) damage to local structures like nerves.
c) 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.
d) the problem recurring. This is similar to the above problem c.
e) rare problems like reflex sympathetic dystrophy (RSD)
f) anesthesia complications are very rare. One figure cited is one death per 200,000 to 300,000 cases, and another is one death per 6 million cases. The serious risks are almost all on very sick patients with multiple medical problems. Serious anesthesia complications are very rare.

Are you taking blood thinner medication? You may have problems with bleeding or development of a hematoma.

I will discuss with you any other complications which might be peculiar to your particular surgery. If you do not feel that I have explained them to you carefully enough, please write down your questions. I will talk to you prior to surgery.

Remember, common things happen commonly and rare things are rare. Know what the possible complication might be, but don't make them more serious than they actually are. Know yourself and act accordingly.
 
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 the hospital. I will talk with you prior to surgery, to answer any last minute questions.


Last updated 6.24.09


 

© Grabow Hand to Shoulder Center.