First Dorsal Compartment Release: Your Journey from De Quervain's to Recovery
In the week leading up to your first dorsal compartment release surgery, your surgeon will advise you to stop taking certain medications, particularly blood thinners, to reduce the risk of excessive bleeding during the procedure. Prepare your home for your return by setting up a recovery area with easy access to essentials. Some hospitals offer pre-operative classes to familiarize you with the procedure and recovery process. Continue any prescribed exercises to maintain flexibility in your unaffected hand and wrist.
The night before surgery, follow your surgeon's instructions regarding fasting. Typically, you'll need to stop eating and drinking after midnight (NPO - nil per os). This precaution helps prevent complications during anesthesia. Take a shower using antibacterial soap as directed to reduce the risk of infection. Get a good night's sleep to help your body prepare for the procedure. Set out loose-fitting clothes for the next day, ensuring easy access for your bandaged hand and wrist.
On the morning of your surgery, arrive at the hospital or surgical center at the designated time. You'll undergo a preoperative assessment, including a review of your medical history and a check of your vital signs. The surgical site will be marked, and you'll meet with your anesthesiologist to discuss the anesthetic options. First dorsal compartment release is typically performed under local anesthesia and usually takes about 30 minutes to an hour.
Immediately after the surgery, your hand and wrist will be bandaged with a light dressing. You may experience some pain or discomfort as the anesthetic wears off. Pain management will begin right away to keep you comfortable. Most patients can go home on the same day, once the effects of anesthesia have worn off. Before discharge, you'll receive instructions on caring for your incision and managing pain at home.
Unlike some orthopedic surgeries, first dorsal compartment release doesn't typically involve strict weight-bearing restrictions. However, you'll have a 5-pound lifting restriction for the first few weeks. Your surgeon will provide specific guidelines on when you can begin gentle movements and gradually increase hand use. Generally, you should avoid gripping or lifting heavy objects for the first 3-5 weeks after surgery.
The first week after surgery focuses on rest, pain management, and protecting the surgical site. Keep your hand elevated to reduce swelling. The dressing should remain in place for about 3-5 days and kept dry. You may experience some pain and swelling, which can be managed with prescribed pain medication and ice packs. It's crucial to follow your surgeon's instructions carefully during this time to avoid complications. You'll likely be able to move your fingers immediately after surgery, but avoid strenuous activities25.
Your first postoperative appointment usually occurs about 2 weeks after surgery. During this visit, your surgeon will check your incision healing and remove any stitches if necessary. They will assess your initial recovery progress and may begin to outline a plan for hand therapy if needed. This appointment is an excellent opportunity to ask questions about your recovery progress and discuss when you can safely return to specific activities58.
Moderate activity recovery typically begins around 2-3 months after surgery. By this time, you may be able to resume most daily activities and potentially return to work if your job doesn't involve heavy use of the affected hand. Your hand therapist, if prescribed, will guide you through exercises to improve strength and flexibility. It's important to follow their instructions carefully and not push too hard too fast.
Full recovery from first dorsal compartment release usually takes about 6-12 weeks. Most patients experience significant symptom improvement within days of surgery. By 6 weeks post-surgery, you should be able to return to normal activities without restrictions. However, everyone's recovery is unique, and some patients may take longer to regain full strength and function. Continue any prescribed exercises and follow your surgeon's advice to ensure the best possible outcome.