DR. ZIV CENTER FOR ORTHOPAEDIC SPECIALISTS
Hand / Wrist / Elbow Postoperative Program
Keep the hand elevated above the level of your heart as much as possible, especially for the first 48-72 hours. A sling is good while standing/ going out for 1 week. After a week the sling is not needed and it is best to use it as little as possible. If you are sitting on a couch, take the sling off and use pillows. Sleep normally, don’t worry about elevating then.
An ice pack placed on the surgical area for 20-30 minutes at a time 2 to 8 times a day likely will help reduce pain and swelling considerably during the first 48-72 hours.
In most cases pain increases substantially several hours after surgery as the local anesthetic wears off - this is normal.
Considerable swelling of the hand and fingers may be seen after even small procedures. This usually starts a few hours after surgery, and peaks on the first or second day after surgery. Ice and elevation will help reduce this.
Moving the fingers frequently if possible helps the swelling and decreases stiffness, even if it is uncomfortable to move the fingers.
Keep the dressing clean and dry. When showering or bathing cover the surgical bandage using a plastic bag secured with rubber bands.
For many procedures (carpal tunnel, trigger finger) you should remove al dressings and wash the incision with soap and water starting on the 5th to 7th day after surgery. Some bleeding at this point is not unusual. After that you can cover the incision with a band-aid but let it air out a few times a day, especially if at home/night leave open to air.
Surgery for fractures, ulnar nerve, Dupuytren’s, thumb arthroplasty, tendon or nerve repair: do NOT change the dressing
Take pain medicine as directed. If taking Vicodin, Norco, Percocet or other narcotic, do not take any extra Tylenol/acetaminophen.
I strongly recommend taking Advil/ibuprofen 3 tablets 3 times a day or Aleve 2 tablets 2 times a day, with food, after surgery, unless you have an ulcer. This will decrease the pain further, help with swelling, and reduce the need for strong pain medication. Do not take this if you are also taking a prescription anti-inflammatory (Naprosyn, Lodine, Celebrex, Motrin, Voltaren, etc.) This is fine at the same time as the prescription pain medication.
Numbness and tingling in the fingers is common in the first day or two and generally improves with time and elevation.
Itching and nausea are often caused by narcotic pain medication and anesthesia. Benadryl can be helpful for itching. Nausea is short-term and does not require treatment.
Intense exercise/workout should be avoided for the first 3 days; it can increase swelling and occasionally cause bleeding of the incision.
Please contact us if you experience unexplained high fever, severe increase in pain, or red streaking of the operated arm.
If the elastic (Ace) wrap feels too tight, you can carefully unwrap it and re-wrap it more loosely without disturbing the dressing underneath.
The postop appointment was made when surgery was scheduled and is on your preop papers, cal the office in a few days if you cannot find it, it is usually in 10-14 days
US Healthworks patients (Chatsworth) must fol ow up in the Chatsworth clinic and call there if there any issues with appointments, medication or work status: (818) 882-8100
CALL FOR ANY URGENT QUESTIONS: 818-264-3344 805-449-0066
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J Clin Endocrin Metab. First published ahead of print March 29, 2013 as doi:10.1210/jc.2012-3888 Growth Hormone Research Society Workshop Summary: Consensus Guidelines for Recombinant Human Growth Hormone Therapy in Prader-Willi Syndrome Cheri L Deal,1 Michèle Tony2, Charlotte Höybye3, David B. Allen4,Maïthé Tauber5, Jens Sandahl Christiansen6, andthe 2011 GH in PWS Clinical Care Guide