Notes, tips & tricks for those affected

Pain Cooling the hand often helps to relieve the pain. Cooling pads, ice packs and frozen goods can be used for this. Frozen food should never be placed directly on the skin; it is advisable to place a drying cloth or pillowcase around the frozen food that is used for cooling. Ointments such as B. Voltaren Emulgel, Voltaren Pain Gel or Lumbinumsoft can help. Before using such a pain reliever ointment, please consult your doctor or pharmacist and read the package insert. The ointments mentioned do not require a prescription and are available in pharmacies from around 6.00 euros.

Differential diagnosis Since cases have recently been discussed in the forum in which a lunate malacia was initially diagnosed and then it turned out that it was something else (e.g. intraosseous ganglion): As a matter of principle, let us clarify exactly whether it is is a lunate malacia. In case of doubt, lunate malacia can be diagnosed or ruled out using an MRI with contrast agent.

Finding a doctor The most important thing in treatment is to have confidence in the doctor treating you. The attending physician should inform the patient about the disease and answer questions after the diagnosis of "lunate malacia". If in doubt about the competence of the treating doctor, it would be advisable to obtain a second opinion.

Before a hand surgery clarification: If the decision has been made that an operation is necessary, you will be informed in detail about the upcoming operation, its advantages and disadvantages and possible risks as well as further treatment options. If you do not understand something, ask directly. Then make your decision in peace.

Outpatient or inpatient: Clarify whether the upcoming operation will be carried out on an outpatient or inpatient basis. Outpatient operations can - with a high standard - be carried out for all interventions that do not involve removal of cancellous bone from the iliac crest or anywhere other than the affected hand. If cartilage removal from the rib or the like is planned, an outpatient operation is also not possible. In the case of outpatient operations, however, it must be ensured that at least the first 24 hours after the operation someone is with you who can look after you and react in an emergency. In the case of inpatient stays, your health insurance company can refuse to pay for the inpatient stay if the operation could have been carried out on an outpatient basis. In the case of inpatient stays, those with statutory health insurance are obliged to pay a contribution of 10.00 euros per day to the costs of hospital treatment for a maximum of 28 days within a calendar year (Section 39 (4) SGB V). If you have supplementary insurance, check before specifying the supplementary insurance whether optional services (treatment by the head physician and / or accommodation in a single or twin room) are covered by it. Supplementary insurance that z. B. Hospital daily allowance, the co-payment of remedies, etc., are not meant by the question of additional insurance with regard to inpatient admission. If you are not covered for the optional services and make use of them, this can mean a severe financial loss for you.

Anesthesia: Clarify the possible forms of anesthesia for the operation with their advantages, disadvantages and risks. When filling out the anesthesia questionnaire, give the most accurate and, above all, truthful information. If you are taking medication, clarify whether it needs to be stopped, etc.

The day before the operation: Because of the upcoming anesthesia, it is important not to eat or smoke after 10 p.m. the day before the operation. After 2 a.m. it is no longer allowed to drink.

After an operation on the hand, it should be held as high as possible so that it is above the heart. Of course, the hand is swollen after an operation, but holding it up prevents the hand from swelling any further. - The hand should also be raised at night. (e.g. with the help of one or more pillows)

After plexus anesthesia: Since the arm after plexus anesthesia can still be numb for a long time after the operation and can therefore not be kept under control as normal, the arm must be held with the help of the other hand. This is especially important so that the hand does not bump into anything and thus cause additional pain after the anesthesia or even complications in the operated hand.

After general anesthesia: Even if you feel fit after waking up from general anesthesia, do not get up for the first time without someone else who can help you. The cycle could "ride a roller coaster" and therefore it is better to take the first steps in the presence of a nurse / doctor's assistant.

The fingers are free - that is, they can and must even be moved. Even if the movement is / can be a bit painful at first, it must be moved so that the tendons of the fingers do not shorten and the movement of the fingers is not additionally restricted.

The hand should be cooled so that the bruise caused by the operation is as small as possible. In addition, the swelling of the hand is kept as low as possible.

There is no need for severe pain. During an inpatient stay, do not hesitate to receive something for the pain. If the operation was carried out on an outpatient basis, have painkillers written down / given to you.

After removal of cancellous bone from the iliac crest: When the "drainage" is out, you can take a shower. However, the plaster should stay on while showering to keep the wound sterile. After showering, the plaster should be replaced with a new one. When you are discharged from the hospital / clinic, you can have a change of adhesive plaster given to you. Do not bathe in the first few weeks. Bathing would make the skin and tissue in the area of the scar too soft in the initial period after the operation. Only when the scar has healed completely and the crust has fallen off by itself (don't help!), A real bath may be taken again.

While the wrist is immobilized, use a garbage bag when showering to protect the entire bandage from moisture. However, if the bandage gets a little damp, you can change the bandage (only the wraps). But be careful: make sure that the wrist is not moved. If the bandage has already been removed for a short time, you can wash your hand carefully with a washcloth (not under running water - risk of the plaster getting something off). However, avoid the wound to prevent bacteria from entering. It is best to leave the plaster on the hand and wash the rest carefully with a washcloth.

To prevent the wraps from constantly "rolling up" when they are put on and taken off and then only need to be straightened again, a long strip of Hansa / Leukoplast can be glued from the top and bottom of the bandage. If you want, you can also get a textile hose from the medical supply store and pull it over the bandage.

Elastic wraps can be washed. In order to maintain the elasticity of the wraps, never wash them with fabric softener. Then the elasticity is retained, the wrap can be used several times and thus exchanged and looks like it did before the wash - only cleaner.