Arachnoiditis :: Ulnar Shortening Osteotomy
Jul 9, 2013
I have just set up an appointment for a ulnar shortening osteotomy here soon and was hoping to possibly get some advise as to what I should expect for my recovery. I had torn my cartilage about four years ago and had it fixed six months ago. For the past two months I have been in a lot of pain and we have found out that my ulnar is pressing into the cartilage and making the injury worse.
I have had a few arthroscopic surgeries and know the recovery to expect for those but this will be my first non-arthroscopic surgery. I believe that my pain level and recovery will be worse and longer due to the plate and screws going in and the larger incision. Also I work at a desk job and am thinking that will take longer to get back to due to the maneuvering of the arm and wrist.
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I am scheduled for an ulnar shortening osteotomy next Friday, and I am having panic attacks about the procedure so I figured I would ask others to share their experiences and maybe someone could answer some questions for me.
First, I am having this procedure due to my winning the genetic lottery and having an abnormally long ulna. This didn't start giving me pain until about a year ago. I woke up one morning and my right wrist hurt like I had slept on it wrong. When the pain didn't go away I went to a local urgent care to see if I possibly sprained it - I had been doing a lot of yoga at the time. They took x-rays, said it must be a strain or pulled muscle, gave me a splint and sent me on my way. For the last year I wore a brace on and off when my wrist gave me pain. The pain has never been constant, it comes and goes. The most disturbing thing about it is that when I rotate my wrist there is something in there that snaps and cracks - probably the TFCC, I learned from my research. I finally decided to see an orthopedist about my wrist as I figured it might be carpel tunnel from my office job. My ortho showed me the long ulna bone in the x-rays, which there is no denying - the ulna is visibly longer than the radius, even to an untrained eye. My MRI shows that there is wear on my TFCC, but no tear. I am developing cysts on my lunate bone, which is from the pressure from my long ulna. My doctor said that the way to fix this was the ulnar shortening osteotomy, which is coming next week.
My concerns about doing the surgery are varied. I am terrified of how much pain I might be in when I come out of the surgery. I know I will have painkillers, but I really don't want to stay on those for any longer than is necessary. I have read other boards about this and it seems like some people had more pain after the procedure than others. I am afraid that this will not be beneficial in the long run. I mentioned earlier that I enjoyed yoga, but my wrist pain has prevented me from doing yoga for the last year. Ultimately, I would like to be able to return to yoga, but since this surgery is essentially breaking my arm for me and then putting a plate in to hold it together, I have doubts about ever being able to return to yoga after this. I am also wondering if this is absolutely necessary. Like I said, the pain is not constant - it wasn't bothering me at all last week. However, since it's degenerative I imagine that this is not unusual, and that if I wait it will progress into being painful more often and that eventually my cartilage will tear. I am 31 years old, and while I don't consider this even close to being "old," it is also easier to bounce back from surgery the younger you are.
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I just had my ulna shortening op on Monday and have been discharged from hospital with a normal bandage. Has anyone else had this? I'm a bit concerned as most post I've read people usually have a cast after the surgery. My surgeon was quite adamant on not placing a cast, but I feel quite unsafe. In fact he wanted to take this bandage off on the day after the surgery. Can anyone recommend any kind of splint I can buy that would help me to feel a bit safer, I have a hyper 4 year old and don't want to risk being hurt. Especially as I can't take all kinds of painkillers, most strong ones give me palpitations and shortness of breath.
I just feel like I've been hacked up with very little after care. My surgeon was very rude and upset to find I had to stay overnight after the surgery. I was very sick from the general and morphine.
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I had an ulnar shortening osteotomy and tfcc debridement on may 24th. I had been misdiagnosed with tendonitis for three years, then an MRI revealed a tear in my tfcc. They cleaned up the tear and then shortened my ulna by 6mm.
So my bone is healing and stable. I have almost all of my range of motion back. But the pain in the soft tissue on the ulnar side of the wrist is worse than before surgery.
I have adjusted my whole life around the pain. I no longer have hobbies, cook my own food, or even pick up my three year old son (which is heartbreaking). The most daunting part of this is that I can not do my job. I can type and email, but I can not use my drawing programs for more than 30 minutes a day without screaming. I have spent my whole life training for this career, and all of a sudden I am no longer able to do the job I am paid to do.
I met with the doctor today and he said there is nothing more he can do for me medically. I don't know if this is a failed surgery or not, but I know that I am no better off than before. I had the surgery because I could no longer do my job, and now I have had the surgery and still can't do my job.
The doctor also said there is nothing he could do for me pain wise.
My questions are:
Is there really nothing they can do for the pain? No shots? Nothing? Am I expected to work in excruciating pain or not at all?
Would I even have a chance at disability? I can work at a computer, I just can't use the skill set I have that makes me employable. I feel like I would have to start from scratch.
Is this considered a failed surgery? Should I get a second opinion? My surgeon is the best in my state and is really nice. I don't know if there is a better surgeon out there.
Do any of you live with chronic pain? How do you do it? Do you have any tips as to where to start?
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My surgeon is suggesting that I get the ulnar shortening surgery to relieve pressure the ulnar side of the wrist as I've torn several ligaments in the wrist. I had a wrist arthroscopy last month so he could see the extent of damage and so he can plan for future surgery if needed. The damage turned out far more extensive than the MRI/arthrogram showed. I have a partial tear of the scapholunate ligament, complete tear of the lunotriquetral ligament and I've worn through the TFCC. I have the typical ulnar sided pain, and pain around the lunate bone but lately, I'm experiencing more and more problems on the thumb side of the wrist.
Has the ulnar shortening surgery helped relieve or reduce symptoms for anyone who also tore ligaments?
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I also have Ulnar Shortening Surgery scheduled for September 23rd and am having second thoughts about going through with it. It's my left arm and isn't THAT painful so I'm thinking that I should leave it alone. There are obviously complications with this surgery and I just don't know if it's worth it. I'd like to ask everyone if they had a chance to go back to before the surgery would they have gone through with it?
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I am 22 years old, and have just been informed that I need to have a Ulnar Shortening done on my wrist. I have had two previous surgeries done to repair my TFCC. I am a little annoyed this is the first their coming across this, and that I now have to have a third surgery. Can anyone tell me their experience with this surgery?
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Honestly, how bad is this thing? I've watched video's of it, prior posts about it.
I've read up about as much as i think possible, would just like to get some live feedback on it. For the most part I've got full function of my hand/wrists, its just somewhat painful sometimes, and when washing my hands, the wrist can feel loose and unstable.
I've had to reschedule my appointment a few times because of work so it's been about two months since I've spoken to my doc(George White, Orlando), I think his plan was 4 weeks cast, 4 weeks sling, 4 weeks PT. is that about the norm?
I "broke" my wrist..i think? when i was around 10, all i remember is when i fell off the monkey bars my ulna/radius was pushed up against my wrist(never broke skin). I'm relatively thin, 5'9 150, and my ulna's have always been slightly pronounced, never thought much of it until in august at the gym. I picked up a heavier dumbbell than i should have and i think my ulna slipped from the set position it's been in all these years and it throbs constantly/causes pain working out now. Its quite a bit longer than it should be so we're getting this done.
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Hi I had ulnar shortening on my right arm on 11/9/13 and have been placed in a full arm cast until I have it taken off on 30/10/13, can anyone advise me on the physio process after the opp and what I'm likely to be able to achieve after periods of time, I'm currently off work as my job needs me to be able to use my arms/ hands at all times, I'm also right handed.
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I have my ulnar shortening osteotomy (USO) booked in 5 days time with my pre-op assessment tomorrow.
I have founds tonnes of useful info but I'm now starting to realise everyone is different.
The main thing I'm finding is the difference in recovery and outcomes with different types and lengths of immobilisation.
So far Im being led to believe that those with some form of above elbow immobilisation in the initial stages have better outcomes compared to those with only below elbow who seem to have had more pain, less motion, and in some cases delayed or malunion of the ulna as well as more pain or issues with the plate or surgery site.
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I am 4 months post op after having a standard USO. Doc removed 4 mm of bone and plated on the outside. The good news is the pain I had become so used to as a result of UIS has subsided but as I recover, i note new aches and pains which I don't like. Since the day after the op i have had quite agonising pain in my elbow. At no point did I have any above elbow immobilisation. All short arm casts for about 7 weeks in all. The pain has improved but still there and worsens when I straighten my arm - leaving me in a constant state of holding my elbow at 90.
Has anyone else had this after USO? If not - did you have above elbow casts/splints? If so, what was it like and did it subside???
The other problem I am having is when i try to pronate my arm (to get my palm facing down). It feels like as the ulna and radius cross with the twist, the screw(s) which protrude through the ulna, seems to be catching on the radius. it is very sore and most of the time stops me pronating.
If you have experienced anything like this please let me know whether it got better. i am already getting worried that the op has caused some kind of issue with my elbow and also that I will have to have plate removed. not part of the plan at all.
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Went for my 3rd f/up post ulna shortening, fixing the TFCC tear and lunate. I graduated now to a splint(almost like the cockup splint) from a Muenster splint and I am to do therapy at home on my own. Mr Dr. Asst went over the X Rays and then I asked her about going to a "hand only" therapist to start getting my area in the wrist, I cannot rotate my hand so my palms will be faced up. It is like it is in neutral position. I asked the Dr. also when he came into the room about going to therapy and he said that "sometimes a therapist has a goal and not always for the good of the patient and that they have had better results of recovery through doing on your own. My friend that lives in Hawaii that invented the Wristwidget said maybe he had a bad experience with a therapist. These are Tom 10 Hand specialist in the Pittsburgh area and his partner works on the Steelers so I trust their Dr. recommendations but find it odd that most everyone on this board had therapy after the cast came off.
I am to return to work in 2 weeks( being off for 2 mo) and I do not see me accomplishing that. I am a data entry worker and need to meet stats every hr. Is this a realistic thing.
What are your therapies that worked. How long was people off before doing a job like mine- posting medical payments.
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I'm having ulnar shortening surgery and tfcc repair this Friday, I've read a bunch of reviews but couldn't find anyone that played golf. I'm an avid golfer which is probably what cause injury, defiantly when i noticed the pain. I have been putting surgery off because of fear of not coming back well from it. But over time it has become much worse and is affecting daily life so I need to have it done regardless. So please if there is anybody that has had this done and plays some type of sport would love to hear experience.
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Hello... I am having an ulnar shortening done on Friday and I am starting to get really nervous about it. I noticed many people on here who have had this procedure talk about having a fiberglass cast for a couple of weeks after the surgery. My surgeon said after I week and a half I would be put in a removable splint and would not have a big cast like I did when I had my TFCC reconstruction. I was wondering if anyone else had heard this??
Also how long does it take to be able to do "normal" activities again? I am a nursing student and have to begin clinicals again in August.
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Day 3 nothing more than discomfort... Is it okay to use the hand and allow rotation of the arm? Going nuts with the itching under the dressing, any suggestions to relieve it?
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I had my ulna shortened in September 2015, and the plate is causing me all kinds of pain. The whole entire ulnar side of my forearm hurts all the time, and any kind of pressure on the plate makes the pain much worse! My next appointment with the surgeon's office is April 14th, and then we'll discuss the removal of the plate and screws. Also, I have a ganglion cyst that appeared under one of my debridement scars that they may need to remove. AND- there is a ligament on the palmar side of my wrist, just below my pisiform bone that is causing a bit of pain. My doctor said that it's not unusual for it to happen, as it can "stretch" too far after the shortening, but it's not exactly common either.
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I've been having issue with my arm for 6 months now, tingling, numbness, burning in my forearm, hand and up to my shoulder. I also have a stiff neck. It all started with pain in my hand,thumb and wrist while using the mouse (I am a computer IT analyst) and slowly started to affect the whole arm, shoulder and neck.
I have had an ultrasound to check for tendonitis, Nerve studies to check for Carpal tunnel and cubital tunnel and they didn't find anything. I had an MRI of my neck and it's normal apart from some cysts adjacent the nerve roots.
One doctor wants me to see an orthopedic surgeon to have them checked and another thinks they are asymptomatic and aren't the cause of my problem.
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I wonder if anyone taking Opana, long acting (la) and short acting (sa).
What is your experience with this med. ?
Did you take anything else before Opana?
I am going thru a very tough time now. My Dr. transitioning me from Oxycontin - LA and Oxycodone - SA because I been on them for a very long time, developed tolerance and stopped working.
Will take 2 full month to finally stop both oxy and take both Opanas.
I was told Opana stronger drug than Oxy, then why I suffer so much from withdrawal symptoms? This is horrible, never had such problem before? I read on Opana forums, where so many people complain about new Opana due to withdrawals. They say old Opana, before 2014, was an excellent drug without problems, but new one causing bad symptoms.
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I was on Oxycontin for 9 years without so much as a hiccup for a side effect. Best pain killer I have ever taken. Not only did it eliminate my nagging back pain from degenerative arthritis, but it also cured my refractory depression. For those of you who aren't familiar with the word refractory it means you do not respond to any type of medication for depression. Those were the best nine years of my life. Then the health company's prescription plan made it impossible for me to continue by throwing up road blocks such as Pre Auth's, that became harder and harder. Formulary changes that they made up as they went along. I would jump one hurtle and they would throw up another. Finally I was running out of meds real fast and they couldn't care less if I was going to crash and go through severe withdrawal. My Family Dr saved me at the last minute by giving me just enough Methadone to keep me comfortable.
I was taking 180 mg of Oxycontin daily for the last six years with a total of taking the drug for nine years. I was so ****** at the Insurance company. So I was off of Oxy for 6 weeks. Then I had switched pain clinics and they had filed an appeal on my behalf for 40mg oxycontin 3x a day. A slight reduction in dose as I had been taking 60mg 3x a day. To my utter surprise the appeal went through and I was back on Oxy's. Now I had to wean myself off of methadone. I worked my way down to 1/2 tablet of 10mg (5mg) a day. Finally I thought I was ready and Oct 1 was my first day without Methadone. It was a horrible withdrawal that lasted a month to get it completely out of my body.
At this point I believe I had set a Guinness book world record for going through withdrawal 3 times in under 3 months. Worst three months of my life. Next month my PM DR wants to bring me back up to full strength at 60mg 3x a day of oxycontin. So off to the pharmacy I go and you know it, they want another freakin Pre Auth. So because it was a Friday and the Pain clinic shuts down at 12:00 noon, I am now without Oxy's for the weekend. So here comes the withdrawal again. The Pre Auth for 60 mg was rejected. Monday morning I was back at the clinic to pick up a script of 40mg Oxycontin which I still had a good Pre Auth. They continued the fight filing an appeal. Meanwhile I called the Insurance company only to find out now they had some new formulary rule that said you have to try at least 3 out of 4 pain relievers they listed. One I never even heard of. The hand writing was on the wall. They simply didn't want to write Oxycontin any more because of the cost. My one prescription of 90 60'smg cost $1460 if you paid out of pocket with no insurance.
So the next time I saw my PM DR I gave up and said forget it, I am tired of beating my head against the wall with the insurance company. So I switched to Opana ER 30mg. Here's the crazy part. This prescription costs over $700. They have a generic called Oxymorphone which is a tier one drug and is a fraction of the cost. The insurance would not let me get the generic and insisted on name brand Opana ER.
I have been on Opana ER 30 2x a day with up to four 10mg fast acting Oxymorphones for break through pain for eight days. By the way conversion is 2 to 1 with Opana ER being the stronger of the two. One 30 Opana ER is equal to a 60mg Oxycontin.
My opinion of Opana ER is it absolutely sucks, it is the worst pain med I have ever taken. It is causing me shortness of breath and extremely severe anxiety. Just the anxiety on a scale of 1-10 is an 8.5. I can't sleep right at night, and with the anxiety I am ready to rip somebodies head off. I am afraid someone is going to set me off and I am not going to be able to stop my aggression. I did speed when I was young and this pill reminds me of the speed, certainly does not act like a pain killer. I know it works for others, but I am not so lucky. I finally hit my wall when the back pain returned at about a 6. That was the deal breaker. So I have put in a call to go back on Monday to pick up a different script for anything but Opana ER.
I was so Happy and pain free for nine years. Why did the insurance company have to take away the best Med I have ever taken and completely destroy my life? It really Blows.
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I had a fusion of my big toe on October 28, 2009. As I approach my first anniversary, I am happy with the results. My joint was severely damaged. The surgeon said I had two choices, cheilectomy and fusion. He did not think the cheilectomy would work for me and if it did, it would only likely last a year. I did some research and realized that I was headed for a fusion. I decided on that and I am glad I did.
My recovery has been good. I did have a couple of scares when the radiologist suggested there might be a bone infection. Fortunately, that turned out not to be the case. I suspect he was confusing healing with signs of infection. At any rate, now that it is a year later, I have pretty much no pain. I am walking every day, usually at least a mile or two each morning. Sometimes I walk up to five or seven miles in one walk. My foot is up for the task. I have started curling for the season now, and my foot is great. The last time I curled, my foot was very sore (pre-surgery). It was so nice to curl without pain! Also, with all my walking, I am in better shape than before, so I curled amazingly well. Scary.
There is some misinformation about fusions I'd like to address: Your gait will be altered with a fusion - my gait was altered by the sore foot and limited range of motion from the arthritis. Now my gait is normal, I toe off the big toe again. That means that now my hip feels better. You won't be able to run or be active - fusion is actually recommended for people who wish to remain active. At least if the foot is damaged beyond a certain point. I am more able to run now than I was pre-surgery because I have a stable foot that does not hurt. Surgery is painful - yes, I had about four days of pain that required medication. After that, as long as I had my foot elevated, I was fine. I think bunion surgery is much more painful
Fusion is certainly a drastic procedure that probably should not be considered lightly. At the same time, if it is the right procedure it is fabulous.
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I am a 40year old woman. I have suffered from hallux rigidus for the last 6 years because of trauma.
Before surgery (which happened in april 013) I had tried all sorts of medications, injections, magneto therapy, you name it I have done it.
In April 2013 I had an osteotomy (NO cheilectomy) to correct it. After 10 months I can finally say the pain has gotten so much worse.
I can't do many things, my foot hurts even if it is not bearing my weight (not walking). Being so young I don't know what do do.
It is ruining my life, personal life (I can't go anywhere cause whenever I walk I am in so much pain) and professional life.
The doctor that operated suggested to do a cheilectomy or a fusion, but considering the result of this operation I am really scared any new intervention will make things worse.
Can anyone suggest a real expert in Europe? Or any other suggestion, I am really desperate.
Many thanks to all of you for reading my post, and thanks to anyone who would be so nice as to try and suggest someone or something.
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