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This handout explains the follow-up care after the surgery to repair your hand fracture. The splint has been placed on your hand for your protection. Please do not begin moving your fingers until you have been advised to do so by your hand therapist. Please avoid lifting with the operative hand. You should have an appointment to begin hand therapy within 3-4 days after surgery. If you do not have appointment scheduled, please contact our office to coordinate one. Please see the pain medication form below for more detailed information regarding the management of your postoperative medications, to avoid pain, nausea and constipation. If the incision is red or if there is drainage coming out of it, please call us right away. The phone number is listed at the bottom of this page. Go to the emergency room if this occurs at a night or on a weekend.

Wound Care:

  • Metal screws or pins (hardware) may be used to repair a hand fracture. These keep the bone in the place until they heal.
  • After surgery, your hand will be placed in a bulky splint. This helps to protect the fracture site and lessen the swelling. When bathing, put a plastic bag around your hand to keep the splint clean and dry.
  • Elevate your hand as much as possible each day, to lessen the swelling and pain.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take your medication as directed. It is important to “stay ahead” of your pain medication and avoid having to play “catch up” for significant increase in pain. Medication for nausea will also be provided. Please take this as directed.
  • Please check with the postoperative nurses and the office staff at Bellevue Bone & Joint Physicians about how to manage your pain medication. To best manage your pain, you must take the pain medication the way it was prescribed. Taking the correct dose at the right time is very important.
  • If you have uncomfortable side effects from the pain medication, please call us at 425-462-9800.
  • Please see “medications after surgery” information form for more instructions.
  • 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 medications, as it is not safe and is 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 will have very little use of the operative hand for about six weeks after surgery until the fractures began to heal.
  • 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 (often in two stages) beginning at about 10-14 days after surgery.
  • We will place your hand in a splint or cast depending on the type of fracture and the stability of the fracture pattern.
  • A therapist, specialist in hand and upper extremity fractures, will help to teach you exercises to lessen the scarring around the incision, increase your hand strength and range of motion.

Results:

Many patients who have hand fracture will regain full use of their hand. Most patients will have some stiffness after the fracture and surgery. There often is a need for secondary surgery to remove the hardware (metal implant) and scar tissue three to four months after the first surgery.


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