Ulna Nerve issues..nearly 2 1/2 years
Let me start at the beginning. In May of 2005, I was injured when a 30 lb (approx gross weight) fell on the palm side of my right (dominant) thumb and twisted my wrist. After seeing a orthopedic surgeon for about two years, without any conclusive test results, I was granted the opportunity to see a hand specialist. An arthrogram was done and a TFCC tear was found, however, I am not sure anyone was looking at the neve issues, as my new Dr seemed surprised to hear about the numbness in my pinky and ring finger, as well as the palm (along the pinky side of the hand) on the day of surgery to correct the tear to the TFCC. At the point of surgery, the numbness in my hand had pregressed to the point that it felt dead...virtually no feeling except pressure. Post surgery, I was able to recover some of the feeling, however, my best guess would be about 20% is still lacking.
After surgery, my Dr has sent me to physical therapy to regain range of motion and strength. While performing a gripping exercise, I noticed (while using the digi-flex) that any time I use my pinky finger (causing the handle to press on the pisiform) the "dead" numbness returns. The physical therapist has now instructed me not to involve the pinky until I see the Dr again in November.
Prior to seeing THIS Dr, nerve conduction studies and Doplar studies were done, but came back negative. However, given this most recent information about the pisiform involvement, I wonder if it is possible that the nerve conduction study produced a false negative, or if the instructions did not incude the possibility that there might be compression at the wrist. I know the new Dr said that most of the tests that were run previously were .... well, I guess not the right tests or were conducted too late (bone scan) to be accurate.
NOTE: It should also be noted that x-rays have revealed that there is a negative varience in both wrists of the ulna bone. The varience has not been calculated, however the current Dr did comment that there was about a 30 degree tilt of one of the bones that caused difficulty in maneuvering the instruments during arthroscopic surgery. It should also be noted that during surgery it was found that the tear was only about a 1mm tear, which was not repaired, however a significant amount of inflamatory tissue was found and removed.
My questions are these, and if anyone has any additional suggestions as to what I should be asking the Dr when I see him, that would be helpful.
1: Is it possible that the nerve conduction study produced a false negative?
2: Is it possible that the nerve could be compressed at the elbow, given how the injury occurred?
3: Removal of the pisiform has been suggested by both the previous Dr and my current physical therapist (who, by the way is also an MD). Is it likely that this would correct the problem? If so, what are the consequences of not having a pisiform (ie. what limitations would be imposed long term, post op? Would it cause instability of the hand/wrist, etc?)
4: If surgery is needed, and given the previous negative results of a nerve conduction study, how would delaying the surgery effect my chances of recovery?
5: If surgery is conducted, how likely is it that additional surgeries will be needed in the future to remove scar tissue, etc.? I know that common practice is to remove a segment of ligament that houses the nerve (the "roof") at the canal in the wrist. If that surgery would be performed, would another be needed after scar tissue grows to replace that segment?
6: Given the condition, and assuming surgery is performed to "correct" the problem, what is the likelyhood that repetative motions of the hand will be a permanent restriction? I am trying to assess my future job prospects, and whether or not I would need to find something completely different from anything I've done in the past. The Dr already ruled out 2 of the three types of work I've ever done, clerical work is all there is left for my previous experience.
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