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What Causes Swelling And Soreness In Right Hand After Rotator Cuff Surgery?
Question: My husband had rotator cuff surgery(rt arm) on XXXXXXX 22. Had swelling of rt hand. follow up on 7-1 concerned surgeon. He had an ultrasound which showed blood clot deep in a vein. (Acute deep venous thrombosis from the axillary vein to the right brachial vein.) Family doc prescribed Zarelta, also on 7-1. No positive change noted, but forearm shows moderate swelling as well as being sore and hot to the touch. Hand is not hot. His next appt is 7-10. What do you think?
Brief Answer:
Continue Zarelta. Monitor laboratory values PT, INR
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem.
Post-arthroscopic deep vein thrombosis is a very rare complication. It occurs because of the minor trauma to the veins on handling during surgery and also the post-op period of immobilisation of the arm. Usually this clot develops within 3 weeks after the surgery.
Zarelta is used in the treatment of clot formation or deep vein thrombosis. It is quite effective, The Doctor has started this drug for him as a trial to see if the clot can resolve this way.
The swelling and pain will be due to venous obstruction and hence blood accumulation in the arm. Once the clot dissolves, the hand will become better, but usually it will ache a bit even after the clot dissolves.
You can keep his arm elevated. Avoid massaging or pressing away the swelling as this can send a piece of the clot from the brachial vein into the heart or lungs and cause complications.
If he ever develops swelling of face, shortness of breath, chest pain or increased arm swelling, it is important to consult his Doctor immediately to prevent complications of possible Pulmonary embolism which can be fatal.
Kindly get him to perform the physiotherapy exercises as advised by his Surgeon.
Some persons are more prone to getting clots and may continue to do so in the future if precautions are not taken. Kindly consult his Doctor about his risk of getting further clots. He may need labratory testing for Bleeding time, Clotting time, PT, aPTT, Factor V levels, Antithrombin III levels.
Keep him well hydrated with about 2 litres of water daily as this will reduce the chances for blood thickening. Eat healthy.
The clot may take a couple of weeks time to resolve or can even take a few months, depending on the organisation of the clot in the vein. In such cases, if the medicine does not work, the clot can be removed by percutaneous catheter. Kindly discuss about these options with your Doctor. Regular weekly monitoring of laboratory values of PT, and INR are necessary to chart the clot dissolving effect of the medicine.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Continue Zarelta. Monitor laboratory values PT, INR
Detailed Answer:
Hi there.
Welcome to Healthcare Magic.
Thanks for the query.
I have read your query and understood your problem.
Post-arthroscopic deep vein thrombosis is a very rare complication. It occurs because of the minor trauma to the veins on handling during surgery and also the post-op period of immobilisation of the arm. Usually this clot develops within 3 weeks after the surgery.
Zarelta is used in the treatment of clot formation or deep vein thrombosis. It is quite effective, The Doctor has started this drug for him as a trial to see if the clot can resolve this way.
The swelling and pain will be due to venous obstruction and hence blood accumulation in the arm. Once the clot dissolves, the hand will become better, but usually it will ache a bit even after the clot dissolves.
You can keep his arm elevated. Avoid massaging or pressing away the swelling as this can send a piece of the clot from the brachial vein into the heart or lungs and cause complications.
If he ever develops swelling of face, shortness of breath, chest pain or increased arm swelling, it is important to consult his Doctor immediately to prevent complications of possible Pulmonary embolism which can be fatal.
Kindly get him to perform the physiotherapy exercises as advised by his Surgeon.
Some persons are more prone to getting clots and may continue to do so in the future if precautions are not taken. Kindly consult his Doctor about his risk of getting further clots. He may need labratory testing for Bleeding time, Clotting time, PT, aPTT, Factor V levels, Antithrombin III levels.
Keep him well hydrated with about 2 litres of water daily as this will reduce the chances for blood thickening. Eat healthy.
The clot may take a couple of weeks time to resolve or can even take a few months, depending on the organisation of the clot in the vein. In such cases, if the medicine does not work, the clot can be removed by percutaneous catheter. Kindly discuss about these options with your Doctor. Regular weekly monitoring of laboratory values of PT, and INR are necessary to chart the clot dissolving effect of the medicine.
I hope I have answered your query.
I will be available to answer your follow up queries.
Regards,
Dr. Aashish Raghu
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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