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Needle Aponeurotomy Care Instructions

The following provides pre- and post-surgical information for Needle Aponeurotomyperformed at The Hand & Wrist Center. We make it a priority to fully inform you of what is going on at all intervals of your procedure, so we hope that this section provides you with key information.

Your Preparation Prior to Needle Aponeurotomy

We know that preparing for any procedure may cause levels of concern of what not to do, what not to eat and drink, and what else you should be aware of prior to the procedure. Rest assured that because this is a minimally-invasive procedure, there is minimal (if any) preparation required.

• First, there are no restrictions regarding eating or drinking prior to your procedure, so feel free to come for your surgery on a full stomach if needed. The only thing we ask is that if you are going to eat or drink before the procedure, please be mindful of how much you eat and drink as there are no restroom breaks allowed during the procedure.
• Please inform us if you have ever had any joint replacements, dental procedures, or have other medical conditions that may require prophylactic antibiotics. If you are uncertain if this pertains to you, check with your original Physician or Surgeon. Please be informed that we will not be able to administer any antibiotics to you on the day of your procedure; therefore, you will need to obtain these from your own Physician.
• Please also inform us if you have ever been diagnosed with any dermatological (skin) condition. We will appreciate you notifying us of any skin disorders/conditions, skin wounds or injuries, and/or skin infections. It is important that you inform us of these, so that we can determine if there are any additional precautions we should take prior to or during your soft-tissue procedure.
• Additionally, we will take the necessary measures to ensure that you are comfortable during your procedure. Please inform us if you have any lower/upper back (or other medical) conditions that would prevent you from lying in a supine position for approximately 30-60 minutes.
• Know that it is normal to feel some anxiety prior to undergoing any procedure, especially when anticipating discomfort from the procedure and/or from knowing that needles are going to be used. If your anxiety originates from a “fear of needles,” this procedure may not be for you; therefore, we recommend that you discuss other alternatives with our Physician. Our Office does not provide sedation for this procedure. Our in-office procedure will require you to be fully awake at all times, which helps our Physician communicate with you at all times – optimizing results. Following your procedure, a “pain medication” prescription is not necessary. However, over-the-counter medications may be used for the management of “pain” symptoms should they occur. Over-the-counter medications are considered to be just as effective (and less expensive) as prescription medications.
• On the day of your visit, if you are undergoing same-day procedure, please be prepared to spend at least 2 hours in our Office. Each patient procedure requires “before and after” preparation on our part. Equally important, we want to ensure that you and our Physician have had enough time to address all necessary issues pertaining to your visit and procedure.

Your Care Following Needle Aponeurotomy

Due to the nature of Needle Aponeurotomy, wounds and bleeding may occur, but these are uncommon. Therefore, minimal post-procedure bandaging may or may not be required for a few days initially. If bandaging will be necessary following your procedure, our Physician will provide you with further instructions following your procedure.

Prescription pain medication is not typically necessary following the procedure. However, in the event of discomfort, patients may elect to take over-the-counter anti-inflammatory medications to help ease these symptoms. If you feel that you need to “take something for pain,” we recommend that you first consult with our Physician, your Primary Care Physician, and/or a Pharmacist prior to taking any medications. Prophylactic antibiotics are usually not necessary, but may be prescribed at the discretion of your prior treating Physician, Primary Care Physician, or our Physician, or under other special circumstances.

For the first 1 to 2 days following your procedure:

• Light dressings, or bandaids, will be placed on the portal sites at the completion of your procedure. These will be covered with dry gauze and then an ice pack. The ice pack should be kept on for 10 minutes each hour for the remainder of the day, and then for a few hours the following morning. You may discontinue the icepack that evening as well.
• The night of the procedure you may remove any dressings (unless otherwise instructed) to gently wash your hand with soap and water. Do not soak your hand for at least 24 hours. Dry the hand well and reapply dressings only if needed or instructed.
• Start moving your fingers as much as possible to prevent stiffness.
• Avoid heavy or forceful gripping, grasping, lifting, squeezing or direct pressure to the treated hand (such as golf, weight-lifting, or forcibly squeezing objects firmly). Immediately following your procedure (and through the first 5 to 10 days following your procedure) you may use your hand for light use, or helper hand activities. The purpose of avoiding heavy activity for several days is to minimize the possibility of tendon ruptures or other soft-tissue ruptures following the injection of diluted cortisone solutions during your procedure.

Occasionally, night splints or custom-fabricated splints are utilized to help maximize return of extension. If this is necessary, our Physician will provide them to you on the day of your procedure.

Lastly, do not be concerned if numbness and tingling sensations and/or pain is present in the treated hand following your procedure. This is expected for several hours to possibly a few days following your procedure. These symptoms will begin to diminish. However, if these symptoms do not self-resolve, please contact our Office immediately.

Post-Procedure Follow-Up

Our Physician and Staff will inform you when/if you need to be seen back in our Office following your procedure. In some cases, we may ask to see you at future intervals of 3, 6 and/or 12 months to monitor the possibility for severe contracture recurrence. However, in the event that our Physician indicates that you do not require long-term follow-up, please know that we will be glad to see you at any time.

When Questions Arise

We realize that questions will arise at the time you least anticipate, typically occurring once you have just left our Office. Rest assured that our Office is available by telephone 24 hours per day, 7 days per week. If at any time following your procedure you have any questions, please do not hesitate to contact us at (562) 424-9000. After-hours, our answering service will ensure that your telephone call is attended to as soon as possible. If you have questions of a less-urgent nature, you may contact us by completing any of the Contact Us portals listed throughout our website, which we normally respond to within 24 to 48 hours.

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