This handout explains the follow-up care after ulna shortening osteotomy surgery. The ulna has been shortened and secured with a metal plate because it was too long and was putting pressure on the cartilage in your wrist. This should decrease your pain and improve hand function. You have a drain in place to remove fluid from around the surgery site and to decrease the risk of infection. Please continue to take your antibiotics until the drain has been removed. We can schedule removal of the drain for you at our office in 2 days, or the nurse can instruct you on how to remove this at home. A splint has been set in place to maintain your thumb in as straight a position as possible. Please do not lift anything with the operative hand until instructed to do so after therapy. If the splint feels tight, it’s okay to unwrap and rewrap the Ace bandages. Due to the local anesthetic and regional block that you were given, you may notice a numbness or tingling sensation in your hand or fingers. This is normal and should decrease over the next few hours and 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. You will be scheduled to begin a therapy program within a week after surgery to introduce gentle range of motion exercises and to make a more comfortable splint once swelling has decreased. 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:

  • A plate and screws (hardware) are used to secure the ulna.
  • 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.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take this with your medication as directed. It is important to “stay ahead” of your pain medication and avoid having to play “catch up” for significant increases in pain. Medication for nausea will also be provided. Please make sure to take this as directed.
  • Please make sure to 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 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 will have very little use of the operative arm for about 8 weeks after surgery until the tissue and bone 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:

  • Schedule an office visit with hand therapy within 3 days following surgery if a drain is installed to prevent fluid from accumulating in the surgical site. Oral antibiotics should be taken 4 times a day until the drain is removed.
  • The sutures will be removed 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 ulna shortening osteotomy surgery will regain full use of their arm. Stiffness 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