Care after your hand or finger fracture repair: ORIF
Caring for your wound and surgical dressing
· You will be placed in a splint after surgery. Leave the splint on. It must stay clean and dry.
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· To protect the splint when you bathe or shower, we recommend a cast cover or a double plastic bag with duct tape. However, you shouldn't immerse the splint in water, even with it protected, as the seal is generally not strong enough to keep the water out.
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· If the splint gets a little wet, blow air into it with a hairdryer set on "cool" to dry out the padding on the inside. If the splint gets very wet, it may need to be replaced. Please call Dr. Williams' office.
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· If there is a spot where your splint is rubbing on/irritating your skin, please call Dr. Williams' office. We will work with you to fix the problem.
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· Swelling can fluctuate after surgery. If the splint feels too tight, you may loosen the ace wrap. If it still feels too tight, please contact Dr. Williams' office right away for assistance.
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· The sutures used to close the wound may be buried or may be exposed. If they are exposed, they will be removed 10-14 days after surgery. If they are buried, they will absorb on their own.
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· After your first post-surgical appointment with Dr. Williams, the splint will be removed. Usually, instead of a cast, you will visit with a hand therapist. The hand therapist will make a custom brace for you that can be removed. Dr. Williams will most likely allow you to remove the brace to shower. You can let the water run over the wound and then, after your shower, gently pat it dry and put the brace back on. Do not apply any lotions/salves/ointments until the skin has completely healed. Avoid prolonged immersion of your incision in water (such as tub baths, swimming, hot tubs, and dish washing without gloves) until the wound has sealed.
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· After the skin has healed, it will take some time for the swelling to resolve and the scar to mature. Dr. Williams recommends applying Vaseline or Aquaphor and gently massaging the scar 3-4 times a day for a few minutes at a time to aid in scar tissue breakdown.
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Activity after surgery
· Elevation above the level of your heart will help with pain and swelling. A cold pack may also help. It can be used every 1-2 hours for 20 minutes at a time. Make sure the ice pack is not leaky, and simply place the ice pack over the injured area for 20 minutes at a time, 3-4 times a day.
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· At the time of your surgery, you will be placed in a splint that prevents wrist motion. At your first visit with Dr. Williams after surgery, this will be removed and you will visit with a hand therapist. The therapist will make you a removable brace and may show you some exercises. The brace should be worn at all times except for showers, hand washing, and exercises as instructed by the hand therapist. You will have minimal use of your hand for day to day activities for the first six weeks after surgery. Dr. Williams will provide more specific instructions depending on your fracture. Most patients are allowed to discontinue the brace six weeks after surgery.
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· Stiffness is a common issue with these injuries. The hand therapist will show you exercises to help regain mobility and instruct you on how often they should be performed. These exercises are critical to a good outcome.
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Managing your pain after surgery
· Some discomfort is expected after surgery but with the proper pain control measures, the amount of pain you have can be greatly decreased. We recommend Tylenol and Ibuprofen so long as these medications are safe for you. If you do not know whether these medications are safe for you or if you have had a bad reaction to acetaminophen, ibuprofen, aspirin, or other non-steroidal anti-inflammatory medications (NSAIDs) in the past, please discuss with your primary care doctor before taking them.
· If you are able to take these medications safely, we suggest taking Tylenol and Ibuprofen regularly during daylight hours beginning as soon you get home and continuing for at least the first 1-2 days after surgery. After that point, just take these medications as needed. These medications can be taken together and work together to make each other stronger. These medications should not be taken at the same time as other medications containing acetaminophen, ibuprofen, or other NSAIDs. Please refer to the instructions on the bottle for dosing instructions.
Do NOT take more than 3,000 mg Tylenol in 24 hours
Do NOT take more than 2,400 mg of Ibuprofen in 24 hours
· Dr. Williams may prescribe you a narcotic pain medication after surgery. If so, it is a good idea to take it with food to avoid nausea. Do NOT use alcohol or drive while using narcotic pain medication, as these activities can lead to serious injury or death. Refills of prescription medication cannot be called in to your pharmacy. These must be sent electronically and can only be sent during normal business hours. Please keep track of how many pills you have left and provide 24-hours notice if you require a refill, keeping in mind that the office closes for the weekend at 4 pm on Fridays.
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Follow-up care
· You will have a follow-up appointment scheduled with Dr. Williams and a hand therapist 10-14 days after surgery. If you do not know when this appointment is, please call Dr. Williams’ office to find out.
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When to call your surgeon
· If you experience any fevers, chills, increasing wound drainage, pain that is not controlled, swelling that is not controlled with elevation, or problems with your dressing or wound, or if you have any other questions or concerns, please call Dr. Williams’ office.
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When to call your surgeon
· If you experience any fevers, chills, increasing wound drainage, pain that is not controlled, swelling that is not controlled with elevation, or problems with your dressing or wound, or if you have any other questions or concerns, please call Dr. Williams’ office.
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