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surgery to regain use of hand

by David Tullock
(United Kingdom)

Question: I had my stroke 4 years ago and lost the use of my left leg, arm and hand although I am now able to walk a little with the aid of a stick. My left hand and arm are still pretty much useless; I have restricted movement in my arm but it is very weak. I will admit that I do think this could be partly down to myself, as my left hand is constantly curled and I cannot use it. Therefore my arm is getting no use either. I received almost no physio for my hand and arm and suggested to my stroke doctor that if the hand would work, by using it, it would overcome the problem with my arm naturally. He then referred me to a plastic surgeon who carried out an operation on my arm to reduce the length of muscles and tendons for my fingers in order to make them straighter, although he did advise it may take another operation or two for it to fully work. Unfortunately, it has not worked, and he is now considering a second op.

As I understand it, the reason my fingers do not work is because of damage in my brain (I had a blood clot), therefore no amount of surgery on my hand will resolve this problem. Am I correct in this because I do not want to undergo further surgery if it stands no chance of working.

I have no movement in either my fingers, thumb and no wrist rotation. I look forward to your advice and thank you in anticipation

Mr D Tullock

Answer: I apologize for the late response to your question. Surgery will not cause your arm to move again. Surgery can help with contractures (e.g. it can help straighten bent fingers), but if you have no muscle movement, then surgery would merely be cosmetic to improve the appearance of the hands or for some it would help reduce pain.

Sometimes people have high spasticity and will have botox injections to reduce the spasticity to help make moving easier, and I guess the same applies to this type of surgery, however, if the movement isn't there, then the only effect of these treatments is a more relaxed hand not a functional hand that moves. I would discuss it with your doctor, and specifically ask him, "If I haven't had any movement since my stroke, why would this surgery help my hand?" Let him know that you are not merely looking to relax the hand or cosmetically change the appearance but rather that you want the hand to move, and see what he says. I would consider getting a second opinion from another doctor as well.

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surgery on hand
by: d tullock

Thank you for your reply, I did as you suggested and my doctor said pretty much the same as you did, that the result would be merely cosmetic, I had the botox injections some time ago again to no avail, and I have therefore decided not to undergo anymore surgery, I have found a couple of hand physio suggestions on the net and will give them a go

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