De Quervain’s Release – Post Operative Instructions
Summary:
| Wound | Keep dry for 10 days |
| Scar care | Apply Micropore tape over the scar for 6 weeks |
| Return to work: (Clerical) | As pain permits ( approx. < 1 Week) |
| Return to work: (Manual) | 3 – 6 weeks |
| Driving: | Only after plaster slab removed as pain permits |
| Gym / Non Contact sport | 3 – 6 weeks |
| Swimming | When wound completely healed ( 2 - 3 weeks) |
| Hand Therapy | Rarely required – Only If scar sensitivity or limited range of motion |
| Please note that everyone responds to surgery differently. | |
| Return to work may vary greatly depending on the particular requirements of a job. | |
| Return to driving and work is slower if you have operations on both hands at once. | |
| Return for review | If a problem |
1. Operation Report.
You will receive a copy of the operation report at the time of surgery.
There are specific instructions at the bottom of the report.
Follow-up details are on the outside of the envelope provided.
2. Dry skin: The skin of the hand and forearm may be dry after the operation because the antiseptic used to prepare your hand contains alcohol.
Apply Sorbolene cream to your hand around the dressings immediately post op and to the rest of the hand after a few days.
It is not uncommon for the skin of the hand and forearm to peel after about seven days.
3. There wrist is supported in a plaster slab.
This is held in place by a crêpe bandage.
The outer bandage can be removed after 3 to 5 days to allow removal of the plaster slab and to move the wrist.
The plaster can be put on and off to rest the wrist if need be to relieve pain.
4. Leave the inner crepe bandage intact until you are reviewed in the rooms.
5. Keep the hand dry until day 10 post-op.
After 10 days can then get the hand wet in a shower.
Avoid baths and pools for another few days.
6. At your post operative visit:
- Your wound will be reviewed and the dressing lightened.
- The sutures are buried and will dissolve and do not need to be removed.
- Usually Coban bandage is applied to the wrist. It can be used for a few days for additional support. It can come off for showers.
7. Steristrips:
- Don’t pull the steristrips off (they assist in holding your wound together).
Let them fall or wash off.
They can stay on for a few days to add extra support to the wound.
8. Please note that everyone is different and Recovery periods are variable.
9. Most people will note that their pain is better than before the surgery by day 7 – 10.
10. Occasionally patients will note some transient alteration in the sensation around the scar or extending to the back of the thumb. This is due to retraction on the nerve at the time of the surgery. The multiple branches of the radial nerve extend over the first dorsal compartment of the wrist and need to be gently retracted to release the tunnel.
11. Apply Micropore tape ( 2.5cm skin coloured tape) to the wound for 6 weeks after each shower. This improves the scar by reducing tension on the wound edges and also by avoiding sunlight.
12. Scar: - At 10 days the scar usually looks good but after 3 weeks it goes a purple colour . This is NORMAL wound healing . The scar usually fades to being white after 6 – 12 months.
A persistent thick, raised purple scar ( Keloid Scar) is possible but very uncommon in the hand.
13. Swelling – A degree of permanent thickening over the operation area is normal. The extensor retinaculum has been divided and then repaired again in an extended fashion to prevent the tendons to the thumb becoming unstable. The tunnel is enlarged to reduce the tendon entrapment.
14. Activity: - Forceful gripping or activity should be avoided for 3 - 6 weeks to allow the retinaculum to heal.
Movement of the wrist in neutral is fine but avoid extremes of wrist flexion and extension. The thumb can be mobilised as pain permits.
15. You can return to driving when:
- the plaster has been removed and
- you are confident that you could turn the wheel in an emergency to save yourself or someone else.
- You should be off strong pain killers before returning to driving.
16. Concerns – If you think the wound is infected or if pain is progressively increasing then return for review immediately.
Ring Rooms 9650 – 4382 during week days 8:00 AM – 4:00 PM
The hospital where the surgery has been performed after hours or weekends.
Prince of Wales Private 9650 4000
Kareena Private Hospital 9717 0000
17. Follow up - Most people do not need or want further review after this procedure BUT if you are at all concerned or have any questions please make an appointment to see Dr Myers at any stage for a further post-operative review.