NRAS
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Has anyone had knuckle reaplacement and ulner deviation corrected?

I have severe ulnar deviation in my left hand and right is clawed right in to my palm, can only open fingers about 1/2 inch.

If anyone knows of GOOD surgeons can a message be sent?

15 Replies
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I had 4 knuckle replacements on my right hand about 10 years ago. Best thing I ever did. Not only because my finger drift was corrected but also because it reduced the pain to somewhere near only now and again. I was a secretary at the time and when I went back to work I was able to touch type at almost the speed I had done before.

I don't think I would be allowed to give you the name of my surgeon but I will leave you another message after this one with something to google which may help.

Judi

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I just had my knuckle replacement done 3 weeks ago and I've had no luck finding information on the long term results of the surgery. Would you mind sharing your results? Did you manage to maintain ulnar drift correction for all these years and if so did you use any devices like splints etc. to do so? I'm 31 yo and have had RA for past 16 years. Both of my hands are pretty damaged but I decided to start with left just in case I didn't like the results. Now considering to do my right but a long term outcome info would definitely help me decide. Did you have to give up any activities to maintain you results? I'm trying to preserve the artificial joints for as long as I can because I know because of my age I'll have to through the replecment surgery few more times.

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Try googling 'harry the hand' (I will now try myself to see if it is possible to pick up the web-site)

Judi

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Thanks Judi as soon as I read Harry the hand I instinctively knew who you meant without looking. He was my sister in laws surgeon when she tore a tendon. I initially had contact with him by e-mail about 7 yrs. ago but was worried to go further because I live in Norfolk and was worried about the early post op. need to attend outpatients. I am 74 in June and have had RA 18 yrs. and find travelling a prob. Hands are very bad now.

thankfully not painful but only have very limited dexterity. I was a copy typist but I am sitting here using just lft. index finger and rt. thumb nail.

I have seen a surgeon here who is reluctant to do the surgery and on that basis I was reluctant to let him. Another hand surgeon here has a bad reputation and has already had two goes at my wrist and partially caused my current problem. I tried a clinical negligence suit but got no-where in spite of another hand surgeon telling the barrister the op. was technically flawed, but the excuse was the tendon ruptured due to teno-synovitus caused by RA.

I have a print of my x-ray and I am going to try and e-mail it to Harry and see where I can go from there.

How long were you in hospital and could you have coped alone if you had to as I will have to do..

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Hi Siskin,

Glad you knew the surgeon who did my op.

I had the op on the Wednesday afternoon and was out on the Friday. My physio and post-op appointments were carried out at my local hospital as that is where I initially saw Mr. 'B' although the op itself was carried out at his usual hospital (renown for the guinea pig club). The nurses and staff could not have been nicer if they tried.

I had to wear a hand brace for a few weeks during the day to keep the fingers in alignment (can't remember how many but it wasn't too hard). Then I wore a resting splint during the night.

My wrists were not too bad at that time so I managed 1 handed and the only help I needed was from one of my daughters on the day I came out of hospital as I wanted a bath and to wash my hair so she helped me then (i could have done it on my own but I hadn't quite got my head around it). From there on in I washed my hair leaning over the bath using the shower with my hand enclosed in a plastic bag. I can't remember exact timing (again) but I think the bandage came off after about 2 weeks and physio started about then as well.

I pre-planned as much as I could. You have to keep the hand raised when sitting down and when sleeping. I managed the sleeping part by moving the bed against the wall and put a load of pillows next to the wall and nestled my arm in between which kept it upright most of the night.

Clothing wise I wore elasticated trousers and knickers with very small sides so I could hook my thumb through to hitch them up. I wore a poncho instead of a coat so all I had to do was pop my head through.

I was in my early 50's when I had the replacements done and was back to work after 3 months (only took that long because I wasn't allowed to drive for a while and as I was in full time employment and had worked for the company for 10 or so years and was on sick pay) I didn't rush.

I can't remember anything else which may be of interest. Ask away if I can help any more.

Judi

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Judi,Thank you for your help it is so much appreciated. I am trying to make up my mind as I have mobility problems and use a crutch in my right hand, the one which is so bad, the thought of not going out because I would be unable to walk or drive seems unappealing. Suppose I could arrange a mid-winter op. I love the idea of a poncho which I may get anyway cos.often have probs. getting fleeces etc over jersey and t shirts, so a poncho in doors will be lovely.

I am so pleased you op was a succes it is nice to hear good news for a change.

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Hi there

I have had both ulna styloids removed and both wrists fused with Stanley pins but my fingers are reasonably straight. Having both wrists fused and ulna's removed has been extremely successful. Our Chief Medical Advisor is Prof. of Rheumatology at Norfolk & Norwich and if you would like me to I could approach him for a recommendation re hand surgeon. He's currently away but let me know if you would like me to do this.

Best

Ailsa (NRAS CEO)

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Hi Alisa, I think I know the Prof. you are talking about as both my surgeries were at NNUH. I can't really think of the name, Someone born North of the border!!!!!!!!?

I would very much like to know who he would reccomend..

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It's David Scott and I am happy to ask him for you but he is away at the moment, north of the border as his mum is quite ill. Can you email me your contact details please? ailsa@nras.org.uk

Best wishes

Ailsa

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Hi Siskin, yes, I have had 6 knuckle replacements and 6 fingers & both thumbs fused (& wrists). These were all done since 2005. I love my finger/thumb/wrist fusions, they have made my fingers & wrists mostly pain-free. But, I have 3 replaced knuckles that are now out of joint. Both long middle fingers & the left index finger.

I was working at the time, and the surgery didn't affect my typing at all. I probably used my hands too much doing things that I shouldn't have, like yard work, etc. The left middle joint slipped right after the surgery, I know that my tendon was stretched before from severe swelling & the Dr didn't tighten it so it didn't help to hold the new joint in place. Now that finger is pushing my index finger out of joint too. They don't hurt at all, they just make my fingers twist & lean towards my thumb. I guess that's the opposite of the ulnar drift that I used to have. On the plus side, I can do a great Star Trek salute now, without even trying.

I hope that you can get some relief, soon.

Christine

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HinTinwoman so glad you are free of pain, hope it stays that way. I will have to ask my grandson what a Star Trek salute is. The only sign I can make is a left hand thumbs up. Not a lot of good when I feel like an index finger vertical salute.(:-))

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I was put off having my knuckles replaced by the hand surgeon and my consultant. I have dislocated knuckles on one hand and slipped tendons on the other. I cannot straighten my hands. They told me the only benefit would be pain relief and as they aren't painful not worth it. Then they went on to tell me the replacements only last 5 yrs, they break easy, theres a very high risk of infection during the op and it wouldn't straighten my hands. Not sure how much of that was true or just trying to put me off because they had enough of a workload already. Been like it for about 6 years now so kinda got used to it and find my own way of doing things. Can't wave, clap, point properly or do the devil horns at heavy metal gigs but I cope with most other stuff.

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Thanks Shelly, I was put off by a surgeon and I felt he didn't want to do it poss. cos. RA can ruin the tendons. I felt he was maybe a bit inexperienced he was very young. Still can't make up my mind.

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had middle knuckle replaced 4 months ago,before could do anything but was painful,now hard to do anything but no pain,go figure. probably would not do again. 57 years old thinking about early retirement because of this.

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Hi fromley thanks for your response, have decided not to go ahead, have had a hip replaced since I posted this question. and cannot face anymore surgery am 76 in a few weeks and I feel the total of 15 ops in my life is enough. Restricted in what I can do but don't want to risk hands becoming painful. My hand are as bad as any you can see on google, but they will just have to stay as they are.

If you take early retirement fromley hope you can enjoy it. As it is only 4 months since op. things may still improve for you. I sincerely hope so.

Regards.

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