This handout explains the follow-up care after surgery to stabilize the extensor carpi ulnaris (ECU) tendon. During surgery, the extensor carpi ulnaris (ECU) tendon was replaced back in the normal location on the ulna and secured to the bone with special sutures. A splint has been used to maintain the arm in position, to allow the tendon to heal without dislocating. Please do not lift anything with this arm during healing. If the splint feels tight, you may unwrap and rewrap the Ace bandages. Because a local anesthetic and a regional block were used, you may notice numbness or a tingling sensation in your hands and fingers for several hours or days. This is normal and should dissipate over the course of the next few days.

If the skin around the incision is red or if there is drainage coming out of it please call us right away. The phone number is at the bottom of this page. Go to the emergency room if this occurs at night or on a weekend. We recommend that you start physical therapy within one week following surgery to lessen the scarring around the incision, improve range of motion, and when appropriate increase your hand and arm strength. If you do not have an appointment to begin post-operative therapy, please contact our office and we will coordinate that for you.

Wound Care:

  • Your arm will be placed in a bulky splint after surgery. This helps to prevent forearm rotation, protect the surgical site, and lessen swelling. When bathing, put a plastic bag around your arm to keep the splint clean and dry.
  • Elevate your arm as much as possible to lessen the swelling and pain during the healing process.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take the pain medication as it is prescribed, taking the right dose at the right time to best manage your pain. As it takes about 1 hour for the medication to take effect, it is important to “stay ahead” with your pain medication and avoid having to play “catch up” for a significant increase in pain.
  • Medication for nausea may also be provided. Please make sure to take this as directed, typically placed under the tongue (sublingually) to be absorbed in the mouth.
  • Please make sure to check with the postoperative nurse or the Bellevue Bone & Joint Physicians staff about how to manage your pain medication.
  • Please see the “Medications After Surgery” form for more instructions.
  • If you have uncomfortable side effects from the pain medication please call us.
  • It is normal to have some pain off and on for approximately one year after surgery, particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medication, as it is unsafe and against Washington state law. Taking medication can make you sleepy and delay your reaction time.

  • Once you are no longer taking narcotic medication, you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • You have very little use of the operative arm for about 8 weeks after surgery, until the tissue heals.

  • Do not lift anything heavier than a pencil or pen until your sutures have been removed and you have been advised to advance your activity by your physician or therapist.

Follow-Up:

  • The sutures will be removed beginning 10-14 days after surgery.
  • Your arm will be placed in a splint or cast, depending on the level of protection needed.
  • A hand therapist will help to teach you exercises to lessen the scarring around the incision, improve range of motion, and when appropriate increase your hand and arm strength.

Results:

Many patients who have surgery to stabilize the ECU tendon will regain full use of their arm. Stiffness, especially with forearm rotation, is common after surgery and decreases with use. Hypersensitivity at the surgical scar can be reduced by rubbing the skin using materials with different textures.


Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD