Phase 1: Protective (0 - 3 weeks postop)

Key points:
1. Goals: to recover from surgery and protect surgical sites from infection and injury.
2. For the majority of people, normal range of motion is allowed.
3. Avoid carrying weight on the operated arm for 2 weeks.
4. Adequate pain control.

Information for patients:

Protect the surgery site from infection and injury.  

1. The dressings need to be kept dry and clean for 7-10 days.  You should avoid getting the dressings wet.
2. The first dressing change will be approximately 1 week post-op.
3. Gentle passive range of motion with your wrist, arm, and hand is allowed.  Avoid sustained arms in outstretched T position in the end ranges of shoulder abduction, extension and elbow extension for 2 weeks.
4. No full weight bearing, heavy lifting, hard wheeling or pulling on the operated arm for 2 weeks.  Note: this may require you to modify your transfers if you are in a wheelchair for approximately 2 weeks.
5. Once the wounds scab over you can shower but do not soak in a bath until you are given the ok by the surgeon.  

Be prepared for extra help for the first few weeks.  

1. If your operated hand or arm is weaker or numb after surgery you may need help with dressing, eating, transferring, and hygiene. For the majority of people, this is not a significant issue, but it is good to be prepared.    

What to do if you have postoperative complications:

Infection?  
If you develop a fever, have increasing pain, swelling, warmth or new drainage at your surgical site, you may have a wound infection.  If this happens, you will need to see your family doctor or seek alternative medical care right away.  You may need antibiotics.

Numbness?
Some slight numbness is common in the arm or hand after surgery and this usually resolves over a few months.    

Swelling?
If your hand swells, you can help reduce this by elevating your arm when sitting or lying down so your hand is higher than your heart.  If it is still swelling, a compression glove (isotoner glove) or compression sleeve can be used.

Scarring?  
Talk to your therapist and surgeon.  There are ways to help minimize scarring, such as minimizing swelling, gentle scar massage (once the incision has healed) and gel sheets (if the scar is raised).  

New pressure areas?
Prevent pressure injuries on your skin by turning every two hours in bed or doing frequent weight shifts in a chair.  

Pain?
Have a plan to manage your pain and seek medical attention if pain is intolerable or is above 6/10.
1. Tylenol Extra Strength 4 times a day is the first choice. 
2. If your pain remains elevated add: Naproxen 500 mg twice a day (okay to take with Tylenol).
3. Tylenol #3 or Tramadol can be substituted for Tylenol Extra Strength by your family doctor.  
4. If your pain feels electric, burning, or nerve-like, ask your doctor for pregabalin (Lyrica) or gabapentin nerve pain medication.
5. Contact our clinic if this doesn’t adequately control your pain.

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