Flexor Tendon 5 days post op
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[00:00:43] He's five days post op, oh my God. It's like a dream, right? You're like, thank the Lord. You came in early. But whatever you see on that first day is going to tell you what potentially could happen. Right? Not all doctors are created equal. Not all patients are created equal. People's bodies respond a little differently.
[00:01:12] Right. And, and I know ethnicity plays, plays a role in terms of scarring and that kind of stuff. So he's five days postop his small finger. So we already know. So these are the things that are kind of going through your right zone tube. [00:01:30] No, man's lamb land. So in your mind, you should already be thinking this is a hard area, and I need to tell him as such along the way, I need to tell him as such that this is a hard area and this is called no, I always say it's called no man zone for a reason.
[00:01:53] I always say that when you, when you cut, what's called a zone two you cut both tendons, usually. What else is going on in zone two? I always I'm like, what else, what else is going in zone two? You touch the tip. Why? Because you wanna know if it's numb, is it numb?
[00:02:22] Because it's the, the P I P right. It was zone two P I P you're always think. Could it be a digital nerve? No. Do you have numbness? Do you have numbness in the tip of my oh no. And this guy was great, cuz he didn't have any pain. I'm like perfect. You have no pain. So in your mind, like in your mind, you're already like, okay.
[00:02:45] Dude's like, it's like this Russian dude he's like toughest nails. I can take it. I don't, but I always think, okay, zone, you know, this guy has no pain, so I'm like, perfect. If he has no pain in my mind, I'm already thinking [00:03:00] like, yeah, I wanna be able to move him. Right. I'm gonna be able to move him faster because he's got no pain.
[00:03:06] No man's land. I'm already thinking, I want to talk to him about how difficult this is. So don't bullshit me. Don't tell me you can't come to therapy. I need commitment. I'm not a wham. Bam. Thank you. Ma'am kind of girl. I need some commitment from you. This type of injury takes work. I know that it looks like it might not be that hard.
[00:03:31] It looks like it's only one finger and you still gotta attach to your body. So you might think that it's not that bad, but this is called no man zone for a reason. And it's because. Tendons. If they get stuck, you're going to need another surgeon. One of the things that I want to help you do is to prevent it.
[00:03:53] If you. if you are too aggressive because you think this is nothing, you can tear your tendon, right? You can rupture tendon and that's going to most likely require two surgeries cuz you have to have the, the grafting you know, with the rod placement and then, then they do another one. Then you have to wait so many months.
[00:04:14] So I'm trying to avoid more complications, cuz I don't want you to think that you can do. and I don't want you to not do anything because if you don't do anything, you need one more surgery. I must have mentioned it [00:04:30] in the hour that I worked with him, like six times, by the end of the session, he was like, I'm not going to rupture him.
[00:04:39] I'm not, it's not gonna get stuck. so, but I like on that first day, like I drill it in, I drill. numbness. So he came in with a postop dressing that was like this. So he was, unfortunately ulner deviated flexed. And then this was his finger right now. He was in probably about 20 degrees of. So in my mind, I'm thinking, well, was it intentional to be a function or sometime, you know, they just get casted that way.
[00:05:15] Well, he came in and he, I was like, oh, do you have any numbness? No. No. So if he doesn't have any numbness and I, I mentioned and said, well, I didn't see anything about a digital, like a nerve repair. Do you remember hearing anything about, did you cut the little nerve on the sides of your finger cuz that's, what's gonna cause some of your numb.
[00:05:35] And he said, no, I didn't cut the nerve. Like I have full sensations. Perfect. I don't need to worry about keeping his finger inflection because he's five days postop the small finger already. I'm telling myself. So if it's a zone two, he cut superficialis and he cut his profundus. Right. So it's the [00:06:00] profundus here.
[00:06:01] where I'm not allowed to block. Right. So that's just a little key and key my brain. I'm not gonna be blocking the small finger and all that good stuff. So his finger came in really fat and it came in like the incision. So you can always tell the incision it's like zigzag, but it went all the way down his Palm.
[00:06:26] So that told me that when he cut his finger tendon retracts it down a little further, and usually they have to find it sometimes when they find it, they just do a little cut like this and then they go searching for it. But he might not have been able to find it so that the incision's like much longer.
[00:06:47] So the bigger the wound, you know, the thicker, the swelling, I start thinking wound. right. Wound care.
[00:07:01] Hey, thanks for listening to Hoang's world podcast. If you are brand new to the hand therapy world, head over to my website, www . Hand therapy secrets.com, where you can get started with some of our free guides and paid programs for both OTs and PTs diving into the world of hand therapy. Or if you've been listening for a while watching on our YouTube channel and you think you could benefit from developing and moving your career further along in hand therapy, reach out to me and my team at info @ Hand [00:07:30] therapy.secrets.com and tell us exactly what you're looking for, By the way, if you know someone who could benefit from today's show, please share.
[00:07:38] Thanks. See you on the next episode.
