Surgical Outcome

 

There are always small risks and potential compications with any surgical procedure, however minor or complex. Every competent surgeon attempts to reduce these potential complications to an absolute minimum but it is not possible to give a 100% guarantee. It is the duty of the surgeon to reduce the risks and complications but equally it behoves the patient to accept the responsibility of following the post-operative advice.

Outcome following hand surgery is a partnership between patient, surgeon and hand therapist (if required). Each partner has an equal share in attempting to reduce the risks of mishap to a minimum and to strive to achieve an acceptable outcome to all. It is my usual practice to state to each patient what I believe is a reasonable, pragmatic aim of the surgery I am planning. Clearly this can vary enormously between patients depending upon the severity of the individual's condition. There is always a potential difference between a patient's expectation of surgery and that of the surgeon. Thus, I attempt to define what I believe is my expected outcome and I hope that my patients will be forthcoming in either accepting that prediction or questionning it, so that a discussion can ensue. It is absolutely critical that both patient and I reach an amicable agreement on that predicted outcome.

It is my experience that there is enormous variation in healing rates between patients. Some people heal extremely quickly and others much slower. Some patients know which group they fall into. Some patients are very tolerant of pain others are not. These "extremes" are all normal variations. If a patient falls outside of these normal ranges then it may indicate an unexpected, perhaps even extremely rare reaction to an aspect of the operative experience, whether surgical, anaesethetic or pharmological. If any of the latter occur then medical advice should be obtained as a matter of expediency.

It is a fact that many patients have a totally unrealistic time span for recovery from surgery. In the vast majority of cases it takes far longer to recover than anticipated. It is an interesting philosophical concept to try and define 'normality' with respect to musculo-skeletal function. If one has suffered chronic pain in the arm for a long time then it is inevitable that the whole arm is going to be weaker. Thus, to regain full stamina without any symptoms, i.e. 'normality' may well take almost as long as the period of initial symptoms. I try to give an idea of my predicted recovery time to each patient but clearly it is entirely individual.