Re Fusion and pain management

[Guest guest]

Hi Jill,

Now sure if this is much help but I had my left thumb MCP joint

fused just over a year ago. I was having a lot of pain, instability

and dislocations in the joint and in the months prior to my surgery

the thumb joint was permanently out of joint. The operation was

preformed under general anaesthetic in a day case unit. The surgeon

removed and the MCP joint and shaped the remaining bone to slot

together before using two large K-wires to pin the new join

together. I was then placed into a very large and heavy POP cast and

sling.

I was in quite a lot of pain following the surgery. The surgical

wound was sore and my whole arm felt rather bruised and battered

from the effects of the surgery. I found the plaster very

restricting and heavy, but fortunately it was replaced with a

lighter fibre glass cast one week after my operation date. I

remained in that, with the pins in situ for a further 12 weeks. The

pins were initially quite sore, but I become more tolerant of them

as time passed and managed reasonably well after about a month.

Following removal of the cast and pins at the 3 month mark, I had to

continue wearing a rigid splint for a further month and begin

rehabilitation to regain mobility in the remaining thumb joints to

compensate for the loss of movement in the middle joint. It was hard

work but I now have very good grip and can touch the base of my

little finger with the tip of my thumb one more.

Pain and stability wise the operation has been a complete success.

The fusion healed very well and the MCP is now a solid bone. The

only down side I have found to the surgery is the instability being

referred to my PIP and Basilar joints now. By stopping one joint

form moving the strain is passed onto those left and they can often

become more problematic. PT can minimise this but it always has to

be a consideration. All in all though I am pleased I had the MCP

fused as it has removed one source of pain and dislocation for me.

Pain management wise I'm afraid I can't comment at present as I am

at the terribly unmanaged stage - currently receiving no pain

control at all as I am intolerant, allergic or unaffected by al the

usual gammit of drugs thrown at us. I am spending a week in hospital

with Prof Bird in the next month or so though where one of our main

priorities is to find some level of control for my pain. It may be

too late for your purposes, but I can let you know how things go if

you would like?

Hope things settle soon for your members in need. Please know they

are all in my thoughts and prayers.

Love and hugs.....Jo

xxx