My doctor wants to saw my arm in half.

September 27, 2017 8:49 PM

I was just diagnosed with Ulnar Impaction Syndrome and a perforated TFCC. My doc wants to shorten my ulnar shaft by 3mm. Does anybody have experience with this or other UIS/TFCC surgery? I'm just trying to get an idea of what to expect. Thanks!
posted by TheCoug to Health & Fitness (6 answers total)

Best answer: You don't say specifically, but if you haven't yet get a second opinion. And maybe a third. There's often more than one way to ...uh do things... best to know what they before you make a decision. (It could well be that surgery is not the only solution, or maybe a different surgery has a higher success rate.) Best of luck!
posted by From Bklyn at 12:56 AM on September 28, 2017 [1 favorite]

Best answer: I'm a nurse but it's been a while since I've been in ortho, so apologize if this isn't super up-to-date. Management may depend a lot on the cause (traumatic vs chronic) of your UIS and perforation and the degree of damage. I believe you can have asymptomatic UIS for a while, so if you've now got a perforated TFCC, you've probably had this going on for some time. I think that for UIS you generally want to try conservative management (sling/prolonged immobilization, steroids, NSAIDs) for a few months before trying surgery; however, with a perforation, I don't know how much rehabilitative effect you'll have without surgery. There are different surgical options (wafer, shortening, debridement, etc) available but recommendations depend on the specifics of your imaging and preferences of your surgeon. That said, it's always good to get a second opinion (and also see PT) before jumping into surgery.

Hopefully someone with more recent/expert experience will be along soon to provide more insight. Good luck!
posted by stillmoving at 1:22 AM on September 28, 2017 [1 favorite]

Best answer: I asked my sister about this post and if this was the surgery that she had. She asked me to post this on her behalf:

Hey I recently went through this! It was a six year, and 2 surgery process from on set of symptoms to surgery April 2016, I hope yours has been faster. Based on your title it sounds like they want to go with cutting your ulna and then repair it with a metal plate? Ask about an ulna waifer procedure. This is a less invasive procedure where they arthroscopically go into your wrist and shave off the length. This has a faster recovery time, doesn't leave hardware in your arm, and in my case was on top of the same incision sites from my TFCC debridement surgery. I took 3 weeks off of work (I work at a school and one of those weeks was vacation or I would have only taken 2). I was pretty exhausted at first and all wrapped in a splint for a week. Then a cast to my elbow for about 6 weeks. OT for a few weeks after that. I have full range of motion and no pain for the first time in 6 years. I am a sign language interpreter so I use my hands all day every day, occasionally my wrist will get sore/tired but that is very rare. Make sure you find a good OT that you trust and tailors the treatment to you, I think that was a huge part of my success with this surgery. If you have any questions ask away!

She doesn't have a Metafilter account, so I can put you in touch via email if you like (memail me).
posted by ddbeck at 6:04 AM on September 28, 2017 [3 favorites]

Best answer: As From Bklyn says, it's ALWAYS good to get a 2nd opinion from a specialist in the specific area if you haven't already done so
posted by Pressed Rat at 9:28 AM on September 28, 2017 [1 favorite]

Do you know where your TFCC is perforated? I'm currently in the middle of a TFCC injury too, but without the ulnar impaction. My doctor explained to me that if my tear is central, he'd go in and debride it and that recovery time is relatively quick. However, he also said that if the tear is peripheral, they'll be able to actually do a repair, but I'll be stuck in a cast that keeps my arm in the palms up position and up past my elbow for about 6 weeks...

I'm currently doing conservative treatment (starting on a new NSAID tomorrow) in hopes of avoiding surgery,but I'm curious to see how your experience ends up!
posted by astapasta24 at 8:54 PM on September 28, 2017

Response by poster: Thanks for the excellent information! Sounds like a second opinion is a good first step.
posted by TheCoug at 8:59 AM on September 29, 2017