Tendon ruptures in hand due to long-term RA

[dearpen1]

I'm 67 and things have reached a chronic stage in my left, dominant hand due to several tendon ruptures affecting middle and ring fingers, which I can no longer extend. I'm now on the Orthopaedic surgeon's operating list, but I am very scared about how I will cope post-operatively, since I already have a very limited range of movement, due to RA affecting many joints. Has anyone had a tendon transfer, and joint arthroscopy in their hands, and what was the outcome?

[Neonkittie17]

Has your rheumy referrered you to a physio at the hospital? They can help with pre and post op exercises and help you put your mind at rest and refer your to the OT too so any aids at home could be thought about in advance, but you’re probably using those kind of help aids already. Hope you can get some expert physio advice and also others on here can reply to you re their experiences which can help you. Good luck.

[KittyJ]

I hope it goes well, I know there’s a long recovery as I have three ruptured finger tendons and so far have put off having the op so would love to hear how you get on.

[Pulfs]

I’ve had a tendon realigned and 3 knuckles replaced in my rt hand. Was successful. Saw a hand physio after op for exercises. Took 6 wks with splint and exercises to get full movement. No problems since . Hope you get a good result x

[3LittleBirds2 in reply to Pulfs]

This is Op I need to, your comment is reassuring! Thank you x

[Sheila_G]

Sorry I can't help but I do hope you get your op soon. Your hand sounds very painful. I am sure there will be someone on here who can offer you helpful information.

[3LittleBirds2]

Hi DP1

I need knuckle replacing and a tendon sorted in my right hand, my left hand is going the same way too.

Like Kitty I have the operation on hold at the moment, what with lockdowns and timings with Rituxumab etc. I was told I would not be able to use the hand for 2 weeks then intense physio and hopefully back to normal by 3 months, but I guess recovery is different in all of us. Pulfs comment is reassuring too!

There are some posts I'm sure about this on here as I found them while waiting for my Op, maybe worth a search.

Good luck x

[Blodynhaul]

Very sorry to hear of your situation. I have chronic issues with my hands, but not to the extent of yours. Sorry I can't help with anything, but wishing you all the best.

[Kags1068]

Hi dearpen1

I'm sorry you're having to face this surgery. Never an easy decision is it? I have had a couple of ops for ruptured tendons, albeit many years ago. The first was in 1985 when I was 16. I'm left-handed and it was a ruptured tendon in my left thumb. They split the tendon in my index finger and transferred it across. I had 6 weeks in plaster, then physio. It was very stiff initially, but fine after a while. It was my first ever op and I was amazed at how "easy" it all seemed. 🙄 Ignorance of youth, eh?!😉

The second was in 1987 when I was 18. I think this may be very similar to your situation. The middle, ring and little finger of my right hand all ruptured at once. They just flopped downwards, and I could only extend my index finger. During the operation, they mended the tendons and removed some bone from my wrist as apparently that was making things worse. I was expecting it to be a breeze again, but it was more painful. In retrospect, I don't think it was because it was a particularly painful op (although painful, obviously). I think it caught me unawares. This time it was 2 weeks in plaster, then about 6 weeks in one splint during the day, and a resting splint at night. The night splint was fine, but the daytime one was a bit of a monstrosity. It was quite cumbersome and I had to get each finger in a kind of little sling, which was then then suspended by elastic to hold the fingers in an extended position, and also allow you to passively exercise by trying to move them downwards with the elastic returning them to their proper position. (Hope that makes sense). I was horrified when I first saw it, but I think that had an awful lot to do with being a vain 18 year old!

It did work, but not as well as the thumb op. Because of the way it was mended, the fingers could no longer move up and down independently. If I extended one, I extended them all. It wasn't awful though, just required some adaptation (which I'm sure you're well used to). So, I didn't get it back to how it was before, but it was better than leaving it as it was.

Things may well be different now, and those splints may not even be used any more.

Unfortunately, because they were all done so long ago, the repairs on both hands have ruptured again. This was only about 10 years or so ago though, so don't let that stop you. It was discussed whether to redo them, but the thumb op would've required tendons taken from my leg, with a low success rate, so I left it. I'm not sure about the right hand, as I decided to try and put up with it. I'm now not certain that was the best idea, as my index finger ruptured too and the other 3 have become less useable over time. Now, they just curl into a little ball in my palm. If I want to hold anything, I have to try and unfurl them with the other hand, and wrap them around whatever it is (as long as it's small and light)!!

I think knowing what I know now, I would definitely still have gone ahead with the op in 1987. Although not perfect, the outcome made my hand much more usable for many years. I think my subsequent decision to leave it and ignore it 10 years ago was probably not the smartest choice. It's just worsened over the years, and I'm told it's very unlikely it can be improved now. I think if you were to leave it, you would likely end up in a worse position and at a point where it was beyond a decent repair.

I would probably want to be clear about what level of use to expect afterwards, and what the process will be - plaster, splints, etc. I think it helps to be forewarned, as I didn't have a clue! Also, I stupidly didn't do enough of the physio at the crucial time, so I'm sure you will be more sensible than that! Obviously the initial period after the op will be very awkward. I don't know if you live alone, but if so, try and plan what kinds of clothes may be easy, microwaveable meals perhaps, and buy a knife/fork combination utensil for eating. Also, (I can't think how to say this delicately), you may need to practise doing, ahem, toileting duties with your other hand. I had steep learning curve on that one!😄

Also, hair washing with one hand (impossible I know), or could you use those shampoo shower cap things?

Hope this might help. Please ask if there's anything else you think I could tell you.

Best wishes X😊