Complications Following Hand Surgery

The following are general and non-specific complications that you may experience after hand surgery. There are also specific complications, associated with certain procedures. Please refer to the relevant page on my website for more information about the specific complications. Additionally, I will always discuss all possible complications when we talk about your operation during our initial consultation.

 

Swelling

Following your operation, swelling is common in the area operated on. If the swelling increases and the affected area looks red, this may indicate infection. If you suspect you are developing an infection, let me know and I will review you and provide you with antibiotics if necessary.

Bleeding

Bruising is also common after operations. There may be some minor seepage from your wound following the surgery and this will settle over time. If you experience steady bleeding from your wound or a collection of blood (a haematoma) beneath the wound, I may need to remove some sutures and/or return you to theatre to stop the bleeding. Again, please contact me immediately.

Infection

Superficial infections are common (5%) after hand surgery and cause redness, swelling, pain and pus around the stitches. Superficial infections tend to settle quickly with oral antibiotics and regular dressings. Deep infections around the tendons and bones are rare and may need admission to hospital for intravenous antibiotics and further surgery. Deep infections may cause longer-term complications such as stiffness.

If you suspect you are developing an infection, please let me know immediately and I will review you and provide you with antibiotics.

Scarring

Every operation leaves scars. Your scar may initially be tender and thickened. It should soften and become more comfortable with time. Your scar may be numb permanently. Firm massage should help the scar improve. I will provide you with information about scar care after the surgery.

Delayed wound healing

Sometimes the wound splits open (dehiscence) or takes a little while to heal. The reasons for this may include infection, bleeding, or poor blood supply to the wound edges. Your wound will heal with dressings, and I will arrange this for you.

Stiffness

Stiffness may be due to swelling, scar tissue or immobility and will be made worse by infection or other complications. I will refer you to a specialised hand therapist to optimise your recovery and allow for safe mobilisation.

Damage to adjacent structures

Other nerves, vessels and structures could be inadvertently damaged during the operation. This is more common in operations that occur after trauma or when there is a lot of scar tissue at the site of the surgery. I will discuss this with you during your initial assessment.

Complex regional pain syndrome (CRPS)

CRPS is chronic pain syndrome that is mediated by nerves. It is not fully understood and surgeons cannot predict who will be affected. Mild CRPS occurs in 5% of patients. It results in pain, stiffness and swelling, out of proportion to the surgery; the pain is poorly controlled by simple painkillers and may be experienced as burning, electric shock like and is very unpleasant. If your pain is not controlled by painkillers, then please contact me – there are excellent forms of pain relief for CRPS, but they need to be prescribed specially. Mild cases will have good resolution; severe cases are very rare, but may leave the limb permanently stiff and swollen. Read more about Complex regional pain syndrome.

Cold intolerance after finger injury or surgery

Cold intolerance is very common after injury to or procedures on your fingers, especially following replantation. The reason for cold intolerance is not clear, but causes an exaggerated response to cold.

You may experience one or more of the four elements to cold intolerance: pain or discomfort, stiffness, altered sensation and colour change. Not every patient experiences all four components. Cold intolerance tends to develop over the first three months following your injury or surgery, and may remain fairly constant over the first 12 months. It may improve over subsequent years but rarely resolves completely. This may cause you difficulty working in cold environments. I strongly recommend you wear top quality gloves that protect your hands from both wind chill and cold.