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Almost 4 months post Ulnar Transposition Revision; burning palm at thumb

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patrick25230
patrick25230

Hi, I'm almost 4 months post Ulnar Transposition revision left arm to remove scar tissue from decompression done a year prior. I am now having a burning sensation palm at thumb as well as thumb, index, and middle finger. Burning runs up back of hand as well. Also, left side from neck through shoulder is very sore and dead by noon. I live on the heat pad and muscle relaxers. I do very controlled, slow stretching/flossing 4x/day and just started on a 1lb weight for forearm strengthening. 

Anyone else having similar issues?

Patrick

0 likes, 5 replies

5 Replies

  • jeremydpbland
    jeremydpbland patrick25230

    Posted

    Those symptoms in the hand are in the territory of the median nerve, not the ulnar nerve. Go and see your GP, surgeon or neurologist. Dr J Bland
    • patrick25230
      patrick25230 jeremydpbland

      Posted

      Hi Dr. Bland, I told my ortho surgeon last month. he did the tap/zinger test all over my arm which was good. He basically said the muscles are now waking up and irritated i.e. going back to work, that I need to give it time. I see him Apr 30 (5.5 mo post op). 

      Does the medial run in the same location as the transposed ulnar (inducing yet another issue). It seems scar tissue formation is the biggest issue with recovery. Any advice on post op preventative maintenance for scar tissue? Doc says there's good and bad scar tissue.

      Also, any advice on self therapy. I've seen PT locally a few time (UNC Chapel Hill Medical) and they gave me a list of ROM/stretching/flossing which I do 4x/day. I just started doing 1lb light weight because my arm/neck/shoulder has been extremely sore up until now.

      My goal here is to avoid a 3rd surgery.

      Thank you, 

      Patrick

       

  • jeremydpbland
    jeremydpbland patrick25230

    Posted

    The median nerve is quite well clear of the ulnar nerve. About the nearest the two get to each other is at the wrist, even after attempted transposition at the elbow, and those are very clearly median nerve distribution symptoms you are now describing in the hand. I hope you had some nerve conduction studies done before surgery as they would be quite likely to have used the median nerve for comparison with the ulnar so that there will be something available to compare with now. Dr J Bland
    • patrick25230
      patrick25230 jeremydpbland

      Posted

      Yes, I've had 2, one b4 the decompression and one b4 the revision/transposition. The decompression went south on me almost a year post op, revision revealed a bunch of scar tissue compressing and flattening the nerve into an hourglass, lost a ton of muscle and forearm literally shrank overnight. 

      I'm partial to blame for lack of followup therapy ROM/stretching/flossing as arm felt great first 9 months. Then started fatiguing very quickly, hand ice cold, fingers from guitar playing have not healed since, chronic state of soreness (mainly ring). Now the burning.

      This go-around I want to get therapy right so, just curious what would you recommend for ROM/flossing/stretching? I have a 4 things I do 4x/day and every 2 days I do 3lb weight curls, hammer flexing with an actual hammer. and key punch with some putty.

      Patrick

  • jeremydpbland
    jeremydpbland patrick25230

    Posted

    I wouldn't recommend anything in the way of physiotherapy. a) because I'm not a physiotherapist and b) because I don't know enough about the case to suggest any treatment. However you have provided enough information for it to be clear that your symptoms are not simply those of an ulnar neuropathy so you need a proper diagnostic assessment. My choice of specialist would be a neurologist. Dr J Bland

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