Preparing for Surgery

What can I do before surgery to prepare and get the best result?

The primary goal before surgery is to maximize passive movement in your elbows, hands and wrists. This will improve the outcome of the surgery. Pre-surgical rehab may include:
a. Stretching exercises for your shoulder, elbow, and especially wrist and fingers.
b. You may need to wear splints for part of the day and/or through the night to help stretch stiff finger and wrist joints, or to maintain your range of motion in these joints.
c. Decreasing swelling with the use of a compression glove (isotoner glove) and/or elevate your hands to reduce swelling in your fingers.
d. Strengthening exercises for muscles supplied by the donor nerves.
e. Good pain control so you can do the recommended pre-surgical rehab.

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What can I expect right after surgery?

a. You will have 6-10 cm surgical incisions on the front and back of your lower arm.
b. The dressings will need to be kept dry and clean for 7-10 days.
c. For the first week you need to be careful with your surgical sites.
d. You are allowed to move your arms and hands through normal range for day to day tasks.
e. Some slight numbness is common in the arm or hand after and this usually settles within 6 months of the surgery.
e. It is possible you may have some temporary pain in the arms from the nerve transfers.

Potential risks of surgery:

a. Weakness of the donor muscle (eg. weaker elbow extensionflexion for triceps to axillaryBrachialis to AIN transfer)
b. Wound infection.
c. Nerve pain from the nerve transfer - burning / electric shocks (typically temporary).
d. Numbness or further loss of sensation from donor or recipient nerve areas (typically temporary)
e. Change in the position of the hand or arm - eg. clawing of the hand.
f. General risks of any surgery - anesthetic complications, allergic reaction to medications, bleeding, heart attack, pneumonia, new pressure sores from positioning ect.

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