Quote (Balla @ Aug 1 2020 09:32am)
If you haven’t tried the splinting yet, you may want to discuss it. But if it’s already pretty advanced, you could just go for definitive therapy aka surgery. What you describe also happens in recalcitrant and progressive cases, whereby you develop multiple trigger digits + contracture of a different joint in that same finger (PIP vs MCP now) due to compensation.
Also disagree with above that most surgeons are just after the money. Nothing wrong with being operative heavy too, as surgery is just fun, is definitive, and many surgeries like this one are small. I’d be surprised if they never offered splinting once and that would be a bit odd but who knows. Maybe they assumed it bc it has been ongoing for some time it sounds like? I also say this as someone who is going to be a neurosurgeon - often times surgery will be and should be offered on the first visit, and that’s appropriate therapy.
Surprised they didn’t offer therapy and then goes on to say that surgery should be offered first.
Says surgeons aren’t after money and implies surgeons give a shit but then says that surgery is fun. It’s not fun for the patient.
You also said that surgery is definitive and that’s exactly why my push for therapy first is going on here. One fuckup from the surgeon and he loses sensation of a nerve, whether that’s a motor or sensory one (possible digital nerve involvement iirc) and he could have bowstringing or loss of ROM. Surgery is the most likely outcome but therapy would only help his outcomes. Now I don’t know his specific situation other than what he’s described and if surgery is warranted now.
He more than likely goes to therapy after surgery anyways. There’s absolutely no reason not to go presurgery and try and worse case scenario at least get a baseline before being cut into.