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HAND CONTRACTURE


WHAT YOU SHOULD KNOW

Traumatic contractures of the small joints in the hand can develop after either injury or surgery. Once the limiting scar tissue is mature (usually after 3 months from the last event) no amount of therapy will be able increase motion. All contractures must be considered to potentially involve the joints as well as the flexor and extensor tendons.

MEDICAL HISTORY

Patients typically complain of pain, stiffness, weakness, and loss of hand function. The doctor will ask questions to uncover all the events that led up to or contributed to the development of the contracture. Knowing how the contracture formed is the key in planning to eliminate the contracture.

EXAMINATION

Specific measurements will be made of both the passive (someone else moves the joint by pushing on it) and active (joint is moved by its own tendons) motion of each involved joint. Tests will be done to evaluate the function of the relevant tendons.

ADDITIONAL TESTS: Plain x-rays will show any underlying joint damage that might make achieving good motion more difficult.

TREATMENT OPTIONS

  NON-OPERATIVE SURGICAL RELEASE
CONSISTS OF Outpatient therapy Surgically excising scar tissue from around joints and tendons
FEATURES Stretching exercises and splints Outpatient surgery, patient actively participates in evaluation at time of surgery
ADVANTAGES Avoids surgery Maximum correction possible, used when previous scar is mature
DISADVANTAGES Only effective early when scar tissue is immature Correction proportionate to original problem, some new scar tissue forms after surgery

RECOVERY

Patients must be very committed to their treatment to choose surgical correction of a contracture. Intense outpatient rehabilitation begins immediately after surgery. Patients must perform motion exercises every hour on the hour when awake, seven days a week. Sutures are taken out after 2 weeks in the office. Splints are used at night and sometimes during the day to preserve increases in motion. New scar tissue gradually forms and matures over about a 3-month period after surgery. When therapy is finished after the scar matures patients will have some percentage of motion that is still less than the freedom achieved on the day of surgery.
 
 
 
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  • an experience beyond expectation - 10/06/17
  • With the severity of my injury I am amazed at how functional my wrist is with the amazing team work shown at the office. From the very start the service and care have been outstanding!! I can't thank everyone enough! - 02/23/18
  • Dr. Mark Henry is a true healer; the finest most competent doctor I've ever encountered. I am forever grateful to Dr. Henry and the entire staff for saving my finger and facilitating my complete recovery with grace and seriousness of intent. Thank you. - 01/10/18
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  • Dr. Henry is a tremendous doctor! - 05/22/18
  • very good team work, best clinic - 06/21/17
  • Dr. Henry and his staff are amazing! I was able to get an urgent new patient appointment immediately with surgery that same afternoon. Dr. Henry does an excellent and thorough job explaining my injury and the healing process. Very impressed with his plan of early mobility and physical therapy, which helped restore my function back to normal within 8 weeks of surgery. I would 100% recommend Dr. Henry and his staff! Very pleased and grateful for his help. - 03/23/18
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  • dr henry does an excellent job of explaining the problem and solution, seems extremely competent - 02/07/18
  • The staff is nice and everyone is up on the treatment. I feel confident that I am getting the best care and am glad I came here. - 10/30/17
  • Thank you for repairing my injury and being kind in the process. - 01/10/18
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  • I am really happy with my experience. I always knew what was going on and over time got to know the staff based on how many times I've been here. Most importantly, I feel I got the right treatment for my injury. - 10/19/17
  • best place for treatment of hand and wrist problems. Dr. Henry was recommended to me by a friend who is a medical care professional. - 10/06/17
  • Great Doctor and staff. Luis is a wonderful asset to the staff - 12/18/17
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  • Dr. Henry gave me my wrist back!!! Thank you Dr. Henry!!! - 07/10/17
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  • no complaints hand is coming along very well - 11/06/17
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  • Very happy I came here for the surgery, etc. - 06/09/17
  • MD was very thorough and spent a good amount of time with the patient (me). MD had good bedside manners which you do not see from a lot of doctors nowadays. He also made sure everything was understood and that I was given a chance to ask questions or address any concerns I had. Everyone was courteous and professional. Thank you for making mu visit a pleasant one. - 05/02/18
  • Dr. Henry and his staff are phenomenal. Dr. Henry has a gift for not only treating health issues extremely effectively, but he is extremely thorough and very efficient at communication and explaining everything he is doing and all of clearly outlining your options for future procedures. - 05/11/18










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