Volar Hot Dog Post Surgery
First off, thank you so much Dr. Bland for running this website and moderating these forums. Both are absolute treasure troves of information, and I can't thank you enough for your time.
Now for a question. I had carpal tunnel release surgery 5 weeks ago, but still have what I believe is the "volar hot dog", i.e. mild but noticeable swelling on the ulnar side of the palmaris longus tendon, about an inch proximal to my wrist crease. I'm wondering if this swelling will eventually go down, and, if so, whether I should wait for it to do so before resuming heavy use of the hand. The surgeon who performed my surgery managed to do so with a very small incision, and told me I could resume "full activity" after 4 weeks. But my carpal tunnel journey started after some pretty significant overuse of my hand and some associated tendon issues, so I've been trying to give everything time to heal before resuming my regular regimen of playing piano, guitar and video games whenever I'm not typing for my job. Any thoughts?
Thanks again.
I don't generally see the swelling in hands long after surgery so I think it is fair to say that you can expect it to go away at some point but I know of no specific studies of the issue. Indeed the hot-dog itself only has the status of anecdote - it is regularly mentioned in the literature as an observation but has never been quantified or measured, either in terms of size or frequency of occurrence. No-one even seems to know for sure exactly what tissue it is that is swollen. My own guess is that it is a rather diffuse increase in volume of the soft tissues, including the tenosynovium but also every other tissue in the area, mediated by the same biochemical mediators which increase the carpal tunnel pressure. If that is right then there is no need to wait for it to go down, and indeed some activity may help it to settle by mobilising oedema. JB