Resource A patient experience of hand surgery Eight years after having hand surgery for the first time, Kate made the decision to undergo further surgery on her right hand. She kindly offered to write about her experiences, in the hope that she could support others going through this type of procedure. Print At a glance In this article, Kate writes about this experience with hand surgery, which involved: fusion of the right thumb joint a replacement of the index finger knuckle realignment of the tendons in my index, middle, ring, and little fingers. Kate hoped this surgery would help her regain comfort, function, and a better quality of life. Preparing for surgery Preparing for surgery involved: Stopping her RA biologic medication 2 weeks before and 2 weeks after surgery. Also stopping omega-3 supplements, as they can affect bleeding and healing. Attending 2 pre-operative appointments, one by phone and one in person. At the in-person appointment, the nurse took swabs to screen for infection. She also had a blood pressure check, blood tests and an ECG. Packed a hospital bag, with essentials such as dressing gown and slippers (though she was not expected to need to stay overnight). Making sure she had a waterproof bag ready to cover her bandage/ cast in the shower, to stop them getting wet. Buying stretchy tops and elasticated trousers, as these are easy to put on and take off one-handed. The day of the surgery Kate describes being in hospital for many hours before her surgery took place. The anaesthetist gave Kate a general anaesthetic and a nerve blocker for her right arm. Surgery took about 3 hours and her surgeon said it had gone well. A few hours later, she was able to go home. At 2am, when the nerve block that had been numbing her arm wore off, Kate woke in excruciating pain. She had been discharged without pain relief. She called her doctor that morning, who prescribed strong co-codamol. Recovery One of the hardest parts of recovery for Kate was having to accept help from her husband with simple tasks. These included washing and drying her hair, dressing and cutting up food. After surgery, Kate had appointments with a hand therapist. They gave her a custom, moulded plastic splint to wear for 1 week. This helped keep her fingers in a fixed position. Kate’s biggest recovery set-back came when she noticed two small swellings on her scar. Worryingly, she saw a piece of thread from her stitches poking out of one of them. Undissolved internal stitches had caused these scar abscesses. Her hand therapist carefully removed these stitches, then cleaned and dressed the wound. After this, the skin healed well. Kate used hand exercises to help rebuild strength and flexibility in her right hand. Over time, this came to include a small foam cube, to introduce resistance and tension. Outcome Recovery was longer and more complex than Kate had expected. She wasn’t quite prepared for the physical and emotional toll recovery would have on her. Kate still has some pain and less range of motion than she had before the surgery. It took many months for swelling in her hand to go down, but a year on she has no swelling. Kate’s fingers are visibly straighter. Recovery was difficult, but Kate feels surgery was the right decision for her. Accepting help when needed is something Kate is still working on. Back in 2017, I underwent my first-hand surgery, a tendon realignment procedure. The operation was a success, and for a while, things seemed to be on the mend. As the years passed, the tendons in my hand began to slip again. This pulled my fingers out of alignment, causing increasing discomfort. The knuckle of my right index finger has always been the most troublesome. It is often swollen and the gradual damage my RA is doing to this joint puts me in constant pain. X-rays taken over the years confirmed what I already felt. The joint was getting worse. On top of that, my right thumb began to ache more and more, becoming another source of daily pain. I am fortunate to have been under the care of the same orthopaedic surgeon since my initial operation. He’s been monitoring my condition closely. We’ve had ongoing conversations about the possibility of further surgery. After years of weighing the options, I finally decided to go ahead with further hand surgery in 2025. The next step in my journey involved a complex procedure, which would involve: fusion of the right thumb joint a replacement of the index finger knuckle realignment of the tendons in my index, middle, ring, and little fingers. This describes the procedure, but surgery is not only about physical correction. This operation gives me a chance to regain comfort, function, and a better quality of life. Preparing for surgery I have been on biologic medication for many years. I knew how important managing my medication around the time of surgery would be. My pre-operative journey began with a phone consultation. It was thorough and focused on medications and supplements. My healthcare team advised me to stop taking my biologic two weeks before the procedure. I would not be restarting my biologic until two weeks after surgery. This is a precaution to reduce infection risk and support healing. I was also advised to stop my Omega-3 supplements, as they can affect bleeding and healing. The second pre-op appointment was in person and more clinical. It included a blood pressure check, blood tests and an ECG. A nurse swabbed my nose and groin, to screen for infection. I wasn’t expecting an overnight stay after the surgery, but packed a hospital bag just in case. This included a dressing gown, slippers, and essentials for comfort. From my previous surgery, I knew the importance of having a waterproof bag for showering. I knew I wouldn’t be able to get the bandage or cast wet for at least a week. I also stocked up on elasticated waist trousers and stretchy t-shirts. I knew I would need clothes that were easier to put on and take off with one hand. Timing worked in my favour. My operation was due to take place on a Thursday, and my husband was able to take Friday off to be with me. Since someone needs to be with you for the first 24 hours post-op, his support was essential. With the weekend following, I also had my kids around to help during those crucial early days of recovery. The day of the surgery The night before my surgery it was very hard to sleep. I was full of fear and anticipation. I was only allowed sips of water from midnight the night before. I don’t think I could have managed food even if allowed! My check-in time was 7.15am and despite the early hour, the hospital was already buzzing. A nurse greeted me and led me to a small dressing room where I changed into a hospital gown. I put my own dressing gown over the top for warmth and comfort. They gave me a locker to use for storing my belongings. I used this to store my bag, coat and shoes. I pinned the locker key to my hospital gown. I then went to a waiting area, joining other women scheduled for various surgeries. Soon, my surgeon arrived to go over the procedure one last time. They made sure that I was well informed and comfortable with the plan. The anaesthetist explained the medications I would receive. I needed a general anaesthetic, paired with a nerve block in my right arm. The wait was quite long, several hours, so I was glad I’d brought a book to try to take my mind off of it. When it was finally my turn, a nurse walked me to the operating theatre. I lay down on the bed, a pillow placed under my head and the surgical team introduced themselves to me. They placed a pad on my forehead to monitor my sleep, and inserted a cannula. The medication flowed in, and I soon drifted off. I woke up in recovery, feeling groggy and disoriented. The operation had lasted three hours. A nurse was by my side, monitoring my vitals and giving me oxygen. My hand was heavily bandaged from fingertips to elbow and secured in a sling against my body. The surgeon came by to tell me that everything had gone well, though I hardly remember the conversation. After a while, I managed to get up and walk to the toilet. I accepted the offer of a cup of tea and a biscuit, which was very welcome as I hadn’t eaten anything since the night before. A few hours later, the nurse called my husband to collect me. At home, I was grateful the nerve block was still working. I had no sensation in my hand or arm, which meant no pain – yet. Unfortunately, that night, at 2am, I woke up in excruciating pain. The nerve block had worn off, and I realized the hospital had discharged me without any pain relief. First thing in the morning, I called my GP, who prescribed strong co-codamol. Taking it every four hours helped manage the pain during those first intense days. Recovery The first week after surgery was all about recovery and learning to accept help! My hand was still in a heavy cast, and showering became a logistical challenge. I used a plastic bag to keep the dressing dry, but even then, I needed help with the simplest tasks. I needed help washing and drying my hair, fastening my bra and even cutting up food. I couldn’t do any of it alone. Thankfully, my husband stepped in. He cooked, helped me dress, and took care of the little things that now felt like enormous tasks to me. Still, I found it incredibly frustrating. I’m used to being independent. Finding myself having to ask for help with everything was a challenge. After a week, I had my first appointment with the hand therapist. She carefully unwrapped the bandages – an experience that nearly made me pass out. She cleaned the wound and checked the stitches. She then rebandaged my hand with a lighter dressing. That alone felt like progress. She also made me a custom plastic splint, moulded to fit my hand and fingers in a fixed position. Velcro straps held the splint in place. I had to wear it all day, every day for another week. It wasn’t exactly comfortable, but it was a step forward. Just when I thought I was settling into recovery, I hit a small but unsettling setback. A few weeks post-surgery, I noticed two small swellings along my scar. They had turned yellow and looked inflamed. Even more concerning, I noticed a piece of thread was poking out from one of them. At my next hand therapy appointment, I showed them to my therapist. She identified them right away as scar abscesses. These are small pockets of infection caused by undissolved internal stitches. She opened the abscesses and gently removed the leftover thread from my stitches. She cleaned and dressed the wounds again. Thankfully, they then began to heal without further complication. It was a reminder that even with the best care, recovery can be unpredictable. Bodies heal in their own time and in their own way. What matters most is having the right support and knowing when to speak up if something doesn’t feel right. Each week brought a new appointment and a slightly lighter splint. As soon as my team said it was safe to, I began gentle finger exercises. This involved using slow, deliberate movements to start rebuilding strength and flexibility. Later, I would use a small foam cube to introduce resistance and tension to these exercises. This helped me to re-engage strength in the muscles and tendons of my hand. Outcome Four months on from my hand surgery, progress has been steady. Recovery has proven to be longer and more complex than I anticipated though. I still experience pain and I have a little less range of motion in that hand than before the operation. Tasks requiring fine motor skills like fastening buttons or opening packets remain challenging. My hand is still swollen. At a recent check-up appointment my surgeon reassured me that this is normal. They said it could take up to six months to go away completely. My fingers do look straighter, which is encouraging. Despite lingering discomfort and limitations, I’m glad I went through with surgery. It was the right decision for my long-term health and mobility. That said, I wasn’t quite prepared for the emotional and physical toll of the extended recovery time. It’s a journey that demands patience, resilience and a willingness to accept help. This is something I’m trying to learn along the way. One year on One year on, I still experience some intermittent pain. This especially effects the finger where I had the knuckle replacement, but also my thumb. The discomfort still comes and goes, but it’s much less intense. It is far more manageable than it ever was before the operation. The overall appearance of my hand has improved a lot. The swelling (which used to be constant) has completely disappeared. I have a little less movement and strength in my hand, but I always understood the outcome wouldn’t be perfect. Even so, I’ve adapted quite well to the limitations and can do most day‑to‑day tasks easier than I could before surgery. Looking back, I’m genuinely pleased I decided to go ahead with the procedure. Improvements in pain levels, my hand’s appearance and my quality‑of‑life have made the whole process worthwhile. 23/04/2026 Updated: 23/04/2026 Next review: 23/04/2029
At a glance In this article, Kate writes about this experience with hand surgery, which involved: fusion of the right thumb joint a replacement of the index finger knuckle realignment of the tendons in my index, middle, ring, and little fingers. Kate hoped this surgery would help her regain comfort, function, and a better quality of life. Preparing for surgery Preparing for surgery involved: Stopping her RA biologic medication 2 weeks before and 2 weeks after surgery. Also stopping omega-3 supplements, as they can affect bleeding and healing. Attending 2 pre-operative appointments, one by phone and one in person. At the in-person appointment, the nurse took swabs to screen for infection. She also had a blood pressure check, blood tests and an ECG. Packed a hospital bag, with essentials such as dressing gown and slippers (though she was not expected to need to stay overnight). Making sure she had a waterproof bag ready to cover her bandage/ cast in the shower, to stop them getting wet. Buying stretchy tops and elasticated trousers, as these are easy to put on and take off one-handed. The day of the surgery Kate describes being in hospital for many hours before her surgery took place. The anaesthetist gave Kate a general anaesthetic and a nerve blocker for her right arm. Surgery took about 3 hours and her surgeon said it had gone well. A few hours later, she was able to go home. At 2am, when the nerve block that had been numbing her arm wore off, Kate woke in excruciating pain. She had been discharged without pain relief. She called her doctor that morning, who prescribed strong co-codamol. Recovery One of the hardest parts of recovery for Kate was having to accept help from her husband with simple tasks. These included washing and drying her hair, dressing and cutting up food. After surgery, Kate had appointments with a hand therapist. They gave her a custom, moulded plastic splint to wear for 1 week. This helped keep her fingers in a fixed position. Kate’s biggest recovery set-back came when she noticed two small swellings on her scar. Worryingly, she saw a piece of thread from her stitches poking out of one of them. Undissolved internal stitches had caused these scar abscesses. Her hand therapist carefully removed these stitches, then cleaned and dressed the wound. After this, the skin healed well. Kate used hand exercises to help rebuild strength and flexibility in her right hand. Over time, this came to include a small foam cube, to introduce resistance and tension. Outcome Recovery was longer and more complex than Kate had expected. She wasn’t quite prepared for the physical and emotional toll recovery would have on her. Kate still has some pain and less range of motion than she had before the surgery. It took many months for swelling in her hand to go down, but a year on she has no swelling. Kate’s fingers are visibly straighter. Recovery was difficult, but Kate feels surgery was the right decision for her. Accepting help when needed is something Kate is still working on.